K Sri Sita Naga Sai Priya, Taksande Amar
Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Sep 19;16(9):e69718. doi: 10.7759/cureus.69718. eCollection 2024 Sep.
Background Managing critically ill pediatric patients is a challenging responsibility that necessitates effective prioritization and time management. It is important not only to assess the condition of the patient on a continuous and real-time basis but also to assess in a way that will provide vital clues that may help in diagnosis and treatment. Our study aims to investigate the association between echocardiography and clinical systemic examination, to find the association between cardiac dysfunction and pediatric outcomes, and to identify the indications and necessity of echocardiography assessments and therapeutic interventions for patients in the pediatric intensive care unit. Methods This cross-sectional study was conducted in the pediatric intensive care unit (PICU) of the pediatrics department at Datta Meghe Institute of Higher Education and Research, Wardha, India. All critically ill pediatric patients admitted to the PICU underwent echocardiography. The study primarily focused on the indications for echocardiography, the association between systolic and diastolic dysfunction and patient outcomes, and the therapeutic interventions implemented based on the echocardiographic findings. Results The study analyzed 139 subjects aged from one month to 204 months, with the majority in the one- to five-year age group, followed by the 10-15-year age group. Cardiac anomalies were identified in 39 out of 139 cases, and cardiac murmurs were present in 27 cases with an almost equal gender distribution in the infantile age group. Dyspnea, edema, and hepatomegaly were the most common indications for echocardiography. Lasix was the most commonly used antifailure drug used in heart diseases. Sixteen individuals had systolic dysfunction, and eight had diastolic dysfunction, with a mortality rate of 62%. There was a significant association between systolic and diastolic dysfunction and mortality. Conclusion Echocardiography is a valuable asset within the PICU, providing critical insights into cardiac function and hemodynamics. By guiding clinical decision-making, it plays a pivotal role in optimizing care strategies, ultimately leading to improved outcomes for pediatric patients admitted with cardiac conditions. Overall, the study emphasizes the complex nature of pediatric cardiac conditions and the necessity for individualized treatment approaches based on distinct diagnoses and clinical indications.
背景 管理危重症儿科患者是一项具有挑战性的职责，需要有效的优先级排序和时间管理。不仅要持续实时评估患者的病情，还要以能提供有助于诊断和治疗的重要线索的方式进行评估。我们的研究旨在调查超声心动图与临床全身检查之间的关联，找出心脏功能障碍与儿科患者预后之间的关联，并确定儿科重症监护病房患者超声心动图评估和治疗干预的指征及必要性。方法 这项横断面研究在印度瓦尔达达塔·梅格高等教育与研究学院儿科学系的儿科重症监护病房（PICU）进行。所有入住PICU的危重症儿科患者均接受了超声心动图检查。该研究主要关注超声心动图的指征、收缩和舒张功能障碍与患者预后之间的关联，以及基于超声心动图检查结果实施的治疗干预。结果 该研究分析了139名年龄从1个月至204个月的受试者，其中大多数在1至5岁年龄组，其次是10至15岁年龄组。139例病例中有39例发现心脏异常，27例有心脏杂音，在婴儿年龄组中性别分布几乎相等。呼吸困难、水肿和肝肿大是超声心动图检查最常见的指征。速尿是心脏病中最常用的抗心力衰竭药物。16人有收缩功能障碍，8人有舒张功能障碍，死亡率为62%。收缩和舒张功能障碍与死亡率之间存在显著关联。结论 超声心动图是PICU中的一项宝贵工具，能提供有关心脏功能和血流动力学 的关键见解。通过指导临床决策，它在优化护理策略中起着关键作用,最终改善患有心脏疾病的儿科患者的预后。总体而言，该研究强调了儿科心脏疾病的复杂性以及基于不同诊断和临床指征采取个体化治疗方法的必要性。
