770: POINT-OF-CARE ULTRASOUND IN THE PEDIATRIC CARDIAC ICU: SURVEY OF USE, NEEDS, AND FUTURE DIRECTIONS
Rattachement africain : us, ca, gb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Introduction: Use of point-of-care ultrasound (POCUS) has expanded rapidly across Critical Care Medicine. It has made procedures safer, while informing and expediting the evaluation of patients with cardiorespiratory failure. Pediatric Cardiac Critical Care is unique in the complexity of its patients and multidisciplinary approach. Despite a large number of cardiologist-intensivists, the field lacks consensus on the appropriate use of POCUS. We endeavored to understand current usage patterns, perspective on appropriate scope, perceived needs, and barriers to POCUS within Pediatric Cardiac ICUs. Methods: A 33-question survey was developed, vetted by the Scientific Committees of the Pediatric Cardiac Intensive Care Society (PCICS) and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI). It was distributed by PCICS, and the results analyzed. Results: Ninety-one CICU providers (75 MDs, 16 NPs) completed the survey, representing 55 institutions and 63% of PC4 centers. Most were dedicated CICUs in the U.S.; 7 were international. 63% were in their first 10 years of practice, 36% in their first 5. Nearly all utilized POCUS for vascular access. US was also used for thoracentesis (76%), paracentesis (58%), and cardiac assessments (68%), including evaluation of cardiac arrest (47%). Chest tubes were most often placed by cardiac surgeons in 75% of CICUs represented, and by intensivists in 25%; intensivists were more likely to use US (85% vs 36%). Use of POCUS for all of the above applications was felt by most respondents to be both feasible and relevant. Ninety-five percent (95%) and 70% of respondents believed that CICU MDs and NPs should use POCUS for limited cardiac assessments, respectively. Barriers include lack of time (54%), education (49%), quality assurance (44%), credentialing (41%), and established workflows (40%). Interestingly, 45% of respondents also cited limitations imposed by peers. Conclusions: Procedural and diagnostic POCUS, including targeted cardiac assessments, are highly relevant to pediatric CICU practice, and felt by providers to be both feasible and in-scope for MDs and NPs alike. Effort should be focused on openly addressing both infrastructural and cultural barriers, in order to ensure that bedside ultrasound is utilized rigorously and safely in our vulnerable CICU patients.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- 770: POINT-OF-CARE ULTRASOUND IN THE PEDIATRIC CARDIAC ICU: SURVEY OF USE, NEEDS, AND FUTURE DIRECTIONS
- Date Crossref
- 14/12/2023
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Children's Hospital of Philadelphia pays non établi dans la noticeOrganisme public
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University of Pennsylvania pays non établi dans la noticeUniversité ou école supérieure
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Philadelphia University pays non établi dans la noticeUniversité ou école supérieure
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Lurie Children's Hospital pays non établi dans la noticeÉtablissement de santé
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Emory University pays non établi dans la noticeUniversité ou école supérieure
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University of California San Diego pays non établi dans la noticeUniversité ou école supérieure
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Rady Children's Hospital-San Diego pays non établi dans la noticeÉtablissement de santé
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Indiana University School of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Indiana University pays non établi dans la noticeUniversité ou école supérieure
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Children's National pays non établi dans la noticeÉtablissement de santé
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Baylor College of Medicine Texas Children’s Hospital pays non établi dans la noticeUniversité ou école supérieure
Children's Hospital of Philadelphia, University of Pennsylvania et Philadelphia University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.