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Weiling CMD, Bei XMD, Lan WMD, Lixue YMD. Recommendations for Operation, Measurement, Reporting and Application of Pediatric Lung Ultrasound: Chinese Experts Consensus. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2021. [DOI: 10.37015/audt.2021.200056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Jagła M, Grudzień A, Starzec K, Tomasik T, Zasada M, Kwinta P. Lung ultrasound in the diagnosis of neonatal respiratory failure prior to patient transport. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:518-525. [PMID: 31361036 DOI: 10.1002/jcu.22766] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/07/2019] [Accepted: 07/14/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Lung ultrasound (LUS) at the point-of-care is a new method that is increasingly used in neonatology. The aim of this study was to determine the utility of the addition of LUS prior to the interhospital transport of neonates with respiratory failure. METHODS LUS was performed on 50 newborns with respiratory failure prior to transport to a tertiary neonatal intensive care unit. We analyzed the performance of LUS for diagnosing the cause of respiratory failure, the concordance between LUS, chest X-ray (CXR) and final clinical diagnosis, and the impact of LUS on clinical decision making before transport. RESULTS LUS sensitivity for the diagnosis of respiratory distress syndrome was 91.3% (95%CI: 70.5-98.5%), and specificity was 92.6% (95%CI: 74.2-98.7%), whereas sensitivity and specificity of CXR were 69.6% (95%CI: 47.0-85.9%) and 81.5% (95%CI: 61.2-92.9%), respectively. For the recognition of pneumothorax (PTX) LUS had a sensitivity of 83.3% (95%CI: 36.5-99.1%) and a specificity of 100% (95%CI: 89.9-100%). For CXR, sensitivity was 16.7% (95%CI: 0.01-63.5%) and specificity was 97.7% (95%CI: 86.4-99.9%). The agreement between LUS and CXR in diagnosing the cause of respiratory failure was substantial (κ of 0.57 [95%CI: 0.40-0.74]) and the agreement between LUS and the final clinical diagnosis was very good (κ of 0.86 [95%CI: 0.74-0.98]). In 42% of the patients, a LUS examination prior to transport indicated the need for endotracheal tube repositioning or PTX decompression. CONCLUSION LUS may be a reliable imaging technique for differentiating the causes of respiratory failure before neonatal transport. Use of LUS may optimize the care of infants during transport.
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Affiliation(s)
- Mateusz Jagła
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Grudzień
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Starzec
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Tomasik
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Zasada
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Przemko Kwinta
- Neonatal Ambulance Team, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
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Baer Ellington A, Kuhn W, Lyon M. A Potential Pitfall of Using Focused Assessment With Sonography for Trauma in Pediatric Trauma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1637-1642. [PMID: 30294795 DOI: 10.1002/jum.14837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 08/23/2018] [Indexed: 06/08/2023]
Abstract
Prospective studies have shown sensitivities of 73% to 88% and specificities of 98% to 100% for using the focused assessment with sonography for trauma (FAST) examination to identify free fluid in adult trauma patients. However, the efficacy of FAST examinations for pediatric trauma patients has not been well defined, and studies looking at diagnostic performance have had varied results. We describe 3 cases of the potential pitfalls of the pediatric FAST examination in pediatric trauma patients using an advanced-processing ultrasound machine. We hypothesize several etiologies for these false-positive findings in the setting of advanced image-processing capabilities of point-of-care ultrasound. We also discuss the reevaluation of clinical algorithms and interpretation practices when using the FAST examination in pediatric trauma.
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Affiliation(s)
- Aimee Baer Ellington
- Department of Emergency Medicine, Sections of Pediatric Emergency Medicine and Clinical Ultrasound, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Walter Kuhn
- Department of Emergency Medicine, Sections of Pediatric Emergency Medicine and Clinical Ultrasound, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Matthew Lyon
- Center for Ultrasound Education, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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Marin JR, Abo AM, Arroyo AC, Doniger SJ, Fischer JW, Rempell R, Gary B, Holmes JF, Kessler DO, Lam SHF, Levine MC, Levy JA, Murray A, Ng L, Noble VE, Ramirez-Schrempp D, Riley DC, Saul T, Shah V, Sivitz AB, Tay ET, Teng D, Chaudoin L, Tsung JW, Vieira RL, Vitberg YM, Lewiss RE. Pediatric emergency medicine point-of-care ultrasound: summary of the evidence. Crit Ultrasound J 2016; 8:16. [PMID: 27812885 PMCID: PMC5095098 DOI: 10.1186/s13089-016-0049-5] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 09/01/2016] [Indexed: 12/19/2022] Open
Abstract
The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed "how to" and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.
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Affiliation(s)
- Jennifer R. Marin
- Children’s Hospital of Pittsburgh, 4401 Penn Ave, AOB Suite 2400, Pittsburgh, PA 15224 USA
| | - Alyssa M. Abo
- Children’s National Medical Center, Washington DC, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Lorraine Ng
- Morgan Stanley Children’s Hospital, New York, NY USA
| | | | | | | | | | | | | | | | - David Teng
- Cohen Children’s Medical Center, New Hyde Park, USA
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O'Brien AJ, Brady RM. Point-of-care ultrasound in paediatric emergency medicine. J Paediatr Child Health 2016; 52:174-80. [PMID: 27062620 DOI: 10.1111/jpc.13098] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2015] [Indexed: 12/13/2022]
Abstract
Point-of-care ultrasound (POC US) is an adjunct to clinical paediatric emergency medicine practice that is rapidly evolving, improving the outcomes of procedural techniques such as vascular access, nerve blocks and fluid aspiration and showing the potential to fast-track diagnostic streaming in a range of presenting complaints and conditions, from shock and respiratory distress to skeletal trauma. This article reviews the procedural and diagnostic uses, both established and emerging, and provides an overview of the necessary components of quality assurance during this introductory phase.
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Affiliation(s)
- Adam J O'Brien
- Emergency Department, Royal Children's Hospital, Melbourne, Victoria
| | - Robyn M Brady
- Emergency Department, Lady Cilento Children's Hospital, Brisbane, Australia
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Abstract
The use of point-of-care ultrasound in the pediatric emergency department is evolving beyond conventional applications as users become more expert with the technology. In this case series, we describe the potential utility of recognizing abnormal anatomy to impact care in the context of possible cancer in pediatric patients. We describe 4 patients with Langerhans histiocytosis, neuroblastoma, Wilms tumor, and rhabdomyosarcoma, in which point-of-care ultrasound was used to facilitate the diagnoses.
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Abstract
We report a case of a false-positive focused abdominal sonography in trauma (FAST) examination in a persistently hypotensive pediatric trauma patient, performed 12 hours after the trauma, suspected to be caused by massive fluid resuscitation leading to ascites. While a positive FAST in a hypotensive trauma patient usually indicates hemoperitoneum, this case illustrates that the timing of the FAST examination relative to the injury, as well as clinical evolution including the volume of fluid resuscitation, need to be considered when interpreting the results of serial and/or late FAST examinations.
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Rosenfield D, Kwan C, Fischer J. Point-of-care ultrasound: An emerging technology in Canadian paediatrics. Paediatr Child Health 2015; 20:67-8. [PMID: 25838776 DOI: 10.1093/pch/20.2.67] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Charisse Kwan
- Deparment of Paediatrics, University of Toronto, Toronto, Ontario ; Department of Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario
| | - Jason Fischer
- Deparment of Paediatrics, University of Toronto, Toronto, Ontario ; Department of Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario
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Kamdar G, Santucci K, Emerson BL. Management of Pediatric Cardiac Trauma in the ED. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2011. [DOI: 10.1016/j.cpem.2011.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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