ULTRASOUND NAVIGATION IN PEDIATRIC INTENSIVE CARE UNIT: REALITIES OF THE PRESENT

Abstract

RATIONALE. In recent years there has been an increasing number of publications demonstrating the efficiency and safety of ultrasound imaging techniques in anesthesiology and intensive care, which reduce the risk of complications during invasive manipulation and detecting life-threatening conditions at the earliest stage; however, the practical implementation of these techniques is associated with great difficulties, and this has served as the basis for this research. RESEARCH OBJECTIVE. To estimate the adherence of experts in pediatric departments of anesthesiology and intensive care to the use of ultrasound imaging techniques in practical use.METHODS. Voluntary anonymous questionnaire survey of heads of pediatric intensive care units in 65 regions of the Russian Federation.RESULTS. Responses were obtained from 32 (38.4%) respondents. In 30% of cases the work experience of specialists of pediatric intensive care unit was around 5-10 years, and there was no relation between the introduction of ultrasound imaging techniques into the routine practice of the departments and the work experience of the specialists. In 100% of the cases, all the specialists participating in the study had 24-hour ultrasound scanner availability. When assessing adherence to the use of ultrasound imaging techniques in providing venous access, in 5 (15%) hospitals it was not used at all and only in 4 (12.5%) medical organizations it was used in 100% of cases. The average frequency of ultrasound imaging techniques use for main vein catheterization is 49 35.5%. Twenty-six (81%) respondents use ultrasonography to assess myocardial systolic function; in 50% it is routine in patients requiring continuous catecholamine infusion. Most frequently, systolic heart function is assessed by the Teicholz method (56%); the Simpson method was used in 34% of cases. Ultrasound imaging to assess pulmonary status is used by 56% of respondents and only in 28% of cases it is a routine in patients requiring control mechanical ventilation. To assess the status of ventilation volume, ultrasound imaging is used in 47% of cases. Assessment of cerebral perfusion and diagnosis of intracranial hypertension syndrome, ultrasound is used in 72% of cases. For the purpose of screening diagnostics of life-threatening syndromes in children with polytrauma, ultrasound imaging methods are used by 56% of respondents, in 44% of cases it is a routine examination. 57% of respondents believe that ultrasound diagnostic techniques are highly effective, and 71% believe that their use provides a high level of patient safety.CONCLUSION. The main obstacle to the wide use of the methods of ultrasound navigation in pediatric intensive care units is the lack of necessary knowledge and practical skills.