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Point-of-care ultrasound in pediatric anesthesia: perioperative considerations.
Curr Opin Anaesthesiol. 2020 Jun; 33(3):343-353.CO

Abstract

PURPOSE OF REVIEW

To review the perioperative applications of point-of-care ultrasound (POCUS).

RECENT FINDINGS

The role of point-of-care ultrasonography for perioperative care is expanding with respect to perioperative application. The imaging approach can complement the physical exam and provide additional information for decision-making in pediatric perioperative medicine. This review will focus on applications in the following organ systems: airway, cardiac, pulmonary and gastric. Specifically, POCUS of the airway has been used to optimize endotracheal tube depth, aid in tube size selection and predict difficulty with laryngoscopy and intubation. Lung POCUS has been used to assess for causes hypoxemia as well as to optimize ventilatory mechanics. Cardiac POCUS has been used for assessment of hemodynamics, valvular and ventricular function. Gastric ultrasound has emerged as an evaluative mechanism of gastric content in the setting of fasting as well as to confirm placement of gastric tubes. The applications of POCUS in the perioperative setting continue to evolve as a reliable diagnostic tool that can assist in timely diagnosis, improve procedural safety and has the potential to improve patient outcomes.

SUMMARY

The utility of perioperative POCUS has been well demonstrated, specifically for examination of the airway, stomach and cardiopulmonary system. It is advisable for the novice sonographer to perform POCUS within the guidelines set by the American Society of Echocardiography regarding basic POCUS. As with all diagnostic modalities, understanding the limitations of ultrasound and POCUS as well as continuous self-assessment is crucial.

Authors+Show Affiliations

Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.George Washington University School of Medicine, Children's National Hospital, Washington, District of Columbia.Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.Arthur S. Keats Division of Pediatric Cardiovascular Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine. Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32324662

Citation

Adler, Adam C., et al. "Point-of-care Ultrasound in Pediatric Anesthesia: Perioperative Considerations." Current Opinion in Anaesthesiology, vol. 33, no. 3, 2020, pp. 343-353.
Adler AC, Matisoff AJ, DiNardo JA, et al. Point-of-care ultrasound in pediatric anesthesia: perioperative considerations. Curr Opin Anaesthesiol. 2020;33(3):343-353.
Adler, A. C., Matisoff, A. J., DiNardo, J. A., & Miller-Hance, W. C. (2020). Point-of-care ultrasound in pediatric anesthesia: perioperative considerations. Current Opinion in Anaesthesiology, 33(3), 343-353. https://doi.org/10.1097/ACO.0000000000000852
Adler AC, et al. Point-of-care Ultrasound in Pediatric Anesthesia: Perioperative Considerations. Curr Opin Anaesthesiol. 2020;33(3):343-353. PubMed PMID: 32324662.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Point-of-care ultrasound in pediatric anesthesia: perioperative considerations. AU - Adler,Adam C, AU - Matisoff,Andrew J, AU - DiNardo,James A, AU - Miller-Hance,Wanda C, PY - 2020/4/24/pubmed PY - 2020/6/26/medline PY - 2020/4/24/entrez SP - 343 EP - 353 JF - Current opinion in anaesthesiology JO - Curr Opin Anaesthesiol VL - 33 IS - 3 N2 - PURPOSE OF REVIEW: To review the perioperative applications of point-of-care ultrasound (POCUS). RECENT FINDINGS: The role of point-of-care ultrasonography for perioperative care is expanding with respect to perioperative application. The imaging approach can complement the physical exam and provide additional information for decision-making in pediatric perioperative medicine. This review will focus on applications in the following organ systems: airway, cardiac, pulmonary and gastric. Specifically, POCUS of the airway has been used to optimize endotracheal tube depth, aid in tube size selection and predict difficulty with laryngoscopy and intubation. Lung POCUS has been used to assess for causes hypoxemia as well as to optimize ventilatory mechanics. Cardiac POCUS has been used for assessment of hemodynamics, valvular and ventricular function. Gastric ultrasound has emerged as an evaluative mechanism of gastric content in the setting of fasting as well as to confirm placement of gastric tubes. The applications of POCUS in the perioperative setting continue to evolve as a reliable diagnostic tool that can assist in timely diagnosis, improve procedural safety and has the potential to improve patient outcomes. SUMMARY: The utility of perioperative POCUS has been well demonstrated, specifically for examination of the airway, stomach and cardiopulmonary system. It is advisable for the novice sonographer to perform POCUS within the guidelines set by the American Society of Echocardiography regarding basic POCUS. As with all diagnostic modalities, understanding the limitations of ultrasound and POCUS as well as continuous self-assessment is crucial. SN - 1473-6500 UR - https://www.unboundmedicine.com/medline/citation/32324662/Point_of_care_ultrasound_in_pediatric_anesthesia:_perioperative_considerations_ L2 - https://doi.org/10.1097/ACO.0000000000000852 DB - PRIME DP - Unbound Medicine ER -