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Use of Speckle-Tracking Echocardiography in Septic Cardiomyopathy in Critically Ill Children: A Narrative Review
J Charmaine Chan1,2, Anuradha P Menon2,3, Alexandre T Rotta4
1Pediatric Cardiology, KK Women's and Children's Hospital, Singapore.
Insights
Speckle-tracking echocardiography (STE) aids in diagnosing pediatric septic cardiomyopathy (SCM) in the ICU. This advanced imaging technique shows promise for assessing cardiac function and patient outcomes in critically ill children with sepsis.
Area of Science:
- Pediatric critical care medicine
- Cardiology
- Echocardiography
Background:
- Septic cardiomyopathy (SCM) in critically ill children with severe sepsis is linked to myocardial dysfunction and increased mortality.
- Conventional echocardiography may not fully capture the extent of cardiac dysfunction in SCM.
Purpose of the Study:
- To review the utility of speckle-tracking echocardiography (STE) for diagnosing and prognosing pediatric SCM in the Pediatric Intensive Care Unit (PICU).
Main Methods:
- Comprehensive literature searches were conducted across major scientific databases (PubMed, Scopus, Web of Science, Google Scholar).
- Studies utilizing keywords such as 'speckle-tracking echocardiography,' 'septic cardiomyopathy,' and 'pediatric sepsis' were selected.
- Data extraction included patient demographics, diagnoses, echocardiographic findings, illness severity, and outcomes.
Main Results:
- STE is a sensitive method for diagnosing SCM and correlates with illness severity.
- STE demonstrates good prognostic value compared to traditional echocardiographic parameters.
- Further research is needed to explore STE's role in assessing biventricular function and guiding treatment.
Conclusions:
- Speckle-tracking echocardiography serves as a valuable addition to conventional 2D-echocardiography for assessing pediatric SCM in the PICU setting.
Objectives:
In critically ill children with severe sepsis, septic cardiomyopathy (SCM) denotes the subset of patients who have myocardial dysfunction with poor response to fluid and inotropic support, and higher mortality risk. The objective of this review was to evaluate the role of speckle-tracking echocardiography (STE) in the diagnosis and prognosis of pediatric SCM in the PICU setting.
Data Sources:
We performed detailed searches using PubMed, Scopus, Web of Science, and Google Scholar. Reference lists of all included studies were also examined for further identification of potentially relevant studies.
Study Selection:
Studies with the following medical subject headings and keywords were selected: speckle-tracking echocardiography, strain imaging, global longitudinal strain, echocardiography, sepsis, severe sepsis, septic shock, septic cardiomyopathy, and myocardial dysfunction.
Data Extraction:
The following data were extracted from all included studies: demographics, diagnoses, echocardiographic parameters, severity of illness, PICU management, and outcomes.
Data Synthesis:
STE is a relatively new echocardiographic technique that directly quantifies myocardial contractility. It has high sensitivity in diagnosing SCM, correlates well with illness severity, and has good prognosticating value as compared with conventional echocardiographic parameters. Further studies are required to establish its role in evaluating biventricular systolic and diastolic dysfunction, and to investigate whether it has a role in individualizing treatment and improving treatment outcomes in this group of patients.
Conclusions:
STE is a useful adjunct to conventional measures of cardiac function on 2D-echocardiography in the assessment of pediatric SCM in the PICU.
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