Cardiac Dysfunction on Point-of-Care Ultrasound Is Associated With Subsequent Use of Vasoactive Medication in...

Area of Science:

• Pediatric Critical Care Medicine
• Point-of-Care Ultrasound (POCUS)
• Cardiology

Background:

• Systemic infections in children can lead to critical illness.
• Assessing cardiac function is crucial for managing critically ill children.
• Point-of-care ultrasound (POCUS) offers rapid bedside cardiac assessment.

Purpose of the Study:

• To determine if reduced ventricular function on POCUS in children with suspected systemic infection correlates with subsequent need for intravenous (IV) vasoactive medications.
• To explore the association between POCUS-identified reduced cardiac function and other clinical outcomes.

Main Methods:

• Retrospective cohort study of pediatric patients (1 month to 21 years) with suspected systemic infection.
• Cardiac POCUS performed by the clinical team before vasoactive therapy.
• Global ventricular function categorized as reduced or not reduced by expert sonographer review.
• Multivariable logistic regression analyzed associations with clinical outcomes.

Main Results:

• Reduced cardiac function on POCUS was found in 8.2% of 329 patients.
• Reduced function was significantly associated with higher odds of IV vasoactive use (aOR=7.9).
• Reduced function also correlated with ICU admission and fewer ICU/hospital-free days.

Conclusions:

• Reduced ventricular function identified by cardiac POCUS in children with suspected systemic infection is a strong predictor of subsequent IV vasoactive therapy.
• POCUS findings of reduced cardiac function indicate greater illness severity and may aid in early risk stratification.
• Excellent interrater agreement supports the reliability of POCUS for assessing ventricular function in this population.