Impact of Focused Echocardiography in Management of Patients in Pediatric Intensive Care Units

NCT ID: NCT06672783

Last Updated: 2024-11-04

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-11-30
• Study Completion Date: 2025-11-30

Brief Summary

Echocardiography is currently considered a key tool for the hemodynamic assessment in Intensive Care Units (ICU), able to identify causes of hemodynamic instability and to quickly guide therapy . Some of its advantages are being a noninvasive method, risk-free, capable of being performed serially and in real time, and analyzed along with clinical data by intensivists. Several studies have demonstrated the positive effect of the use of echocardiography in the management of critically ill patients, changing their treatment in 30%-60% of cases after the test is performed . Echocardiography has been used as an adjunct in predicting patient outcomes. Relevant and easily obtain-able information about hemodynamics is required for effective therapeutic manipulation of circulation in critically ill children ,Hemodynamic monitoring of critically ill infants and children noninvasively using echocardiography has been evaluated comprehensively Echocardiography is an influential procedure that allows direct visualization of the heart, guiding patients' hemodynamic condition at the bedside. This hemodynamic estimate informs physicians to guide therapeutic approaches like volume resuscitation, initiation, discontinuation, alteration of vasopressor therapy and referral for specialist rapidly if cardiac or surgical attempt is necessary Management of critically ill pediatric patients is a demanding task that requires proper prioritization and judicious time management. Multi-system affection with overlap of symptoms often complicates the clinical picture. Hemodynamic assessment has recently taken top priority in the management of critically ill patients, Echocardiography is an integral component of the clinical service in the pediatric intensive care unit (PICU). It is considered a handy bedside imaging modality, and an accurate diagnostic tool that explores a crucial body system. Indications of bedside echocardiography in TINEC (training in intensive care and neonatal echocardiography) include assessing cardiac function, pulmonary hypertension, severe pericardial effusion, and tamponade. Consequently, it serves as a guide for interventions in critically ill pediatric patients and management .

Conditions

Critical Patients in Pediatric Intesive Care

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: DIAGNOSTIC
• Blinding Strategy: NONE

Interventions

echocardiogrphy

Transthoracic echocardiography

• Parameters assessed:

• Right ventricular dimensions and function
• Pulmonary artery pressure estimation
• Valvular function assessment
• Left ventricular dimensions (end-diastolic and end-systolic)o Left ventricular function (ejection fraction, fractional shortening) o

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• All critically ill patients admitted to pediatric intensive care units aged from 1 month Up to 18 years old.

Exclusion Criteria

• non crtical ill patients

• Minimum Eligible Age: 1 Month
• Maximum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Sohag University

OTHER

Sponsor Role: lead

Responsible Party

Doaa Hassan Ahmed

Resident-pediatric department-sohag hospital university

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Sohag university Hospital

Sohag, , Egypt

Countries

Egypt

Central Contacts

doaa H Ahmed, resident

Role: CONTACT

duaa.hassan@med.sohag.edu.eg

01118226083

safaa H Ali, professor

Role: CONTACT

Facility Contacts

Magdy M Amin, professor

Role: primary

References

Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F. Hemodynamic instability in sepsis: bedside assessment by Doppler echocardiography. Am J Respir Crit Care Med. 2003 Dec 1;168(11):1270-6. doi: 10.1164/rccm.200306-816CC. No abstract available.

Reference Type: BACKGROUND

PMID: 14644922 (View on PubMed)

Croft LB, Duvall WL, Goldman ME. A pilot study of the clinical impact of hand-carried cardiac ultrasound in the medical clinic. Echocardiography. 2006 Jul;23(6):439-46. doi: 10.1111/j.1540-8175.2006.00240.x.

Reference Type: BACKGROUND

PMID: 16839380 (View on PubMed)

Manasia AR, Nagaraj HM, Kodali RB, Croft LB, Oropello JM, Kohli-Seth R, Leibowitz AB, DelGiudice R, Hufanda JF, Benjamin E, Goldman ME. Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by noncardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth. 2005 Apr;19(2):155-9. doi: 10.1053/j.jvca.2005.01.023.

Reference Type: BACKGROUND

PMID: 15868520 (View on PubMed)

Ranjit S, Aram G, Kissoon N, Ali MK, Natraj R, Shresti S, Jayakumar I, Gandhi D. Multimodal monitoring for hemodynamic categorization and management of pediatric septic shock: a pilot observational study*. Pediatr Crit Care Med. 2014 Jan;15(1):e17-26. doi: 10.1097/PCC.0b013e3182a5589c.

Reference Type: BACKGROUND

PMID: 24196006 (View on PubMed)

Other Identifiers

soh-Med-24-09-06MS

Identifier Type: -

Identifier Source: org_study_id