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Good Practice Concepts in Pediatric Critical Care Point-of-Care Ultrasound: A Modified Delphi Consensus Initiative
Jamie S Penk1, Vidit Bhargava2, Harsha Chandnani3
1Division of Cardiology, Department of Pediatrics, Northwestern University, Chicago, IL.
Insights
Pediatric critical care experts developed 25 consensus recommendations for point-of-care ultrasound (POCUS) institutional practice, covering clinical use, education, quality assurance, equipment, and research.
Area of Science:
- Pediatric Critical Care Medicine
- Point-of-Care Ultrasound (POCUS)
Background:
- The Pediatric Research Collaborative on Critical UltraSound (PeRCCUS), a subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), convened a workgroup.
- The workgroup aimed to establish early guidance for institutional point-of-care ultrasound (POCUS) practices in pediatric critical care.
Purpose of the Study:
- To define early guidance for point-of-care ultrasound (POCUS) institutional practice in pediatric critical care.
- To foster comprehensive guidelines for the broad adoption of POCUS in pediatric critical care medicine.
Main Methods:
- A modified Delphi method was employed to generate consensus statements.
- An expert multidisciplinary, multi-institutional workgroup was assembled.
- Iterative voting rounds using a 7-point Likert-type scale were conducted until consensus was achieved.
Main Results:
- Consensus was reached on 25 recommendations.
- Recommendations spanned five key domains: clinical application, quality assurance, equipment, education, and research.
Conclusions:
- Consensus recommendations were established for the institutional adoption of POCUS in pediatric critical care.
- These recommendations address clinical use, educational programs, quality assurance, technical requirements, and future research directions.
Objective:
We assembled a workgroup within the Pediatric Research Collaborative on Critical UltraSound (PeRCCUS), a subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), to define early guidance for point-of-care ultrasound (POCUS) institutional practice and foster future comprehensive guidelines for its broad adoption in pediatric critical care medicine.
Design:
A modified Delphi method was used for creating the statements. The first meeting was an open proposal session for workgroup members to suggest items for consideration. This was followed by a cycle of voting for levels of agreement along a 7-point Likert-type scale. Items were reviewed, with only items receiving a score of greater than or equal to 6 progressing to the next stage of voting and lower-scoring items reconsidered, with only consensus items proceeding to the next stage for additional rounds of voting until consensus was reached.
Setting:
Multi-institutional, multidisciplinary, workgroup of experts on POCUS organized within PeRCCUS as a subgroup of PALISI.
Interventions:
None.
Measurements And Main Results:
Consensus was obtained for 25 recommendations across five domains: clinical application, quality assurance, equipment, education, and research.
Conclusions:
We report consensus recommendations for institutions on clinical use, educational programs, quality assurance, technical requirements, and future research opportunities for the adoption of pediatric critical care medicine POCUS.
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