Comparative analysis between ecofunctional by a pediatrician and comprehensive echocardiography by a cardiologist in a pediatric and neonatal intensive care unit

Abstract

Introduction: Bedside ultrasound performed by a non-imaging specialist has proven to be a useful tool in the diagnostic evaluation and performance of invasive procedures. Several clinical situations favor manifestations of hemodynamic instability, especially in intensive care units. Nowadays, several pediatric units have used functional echocardiography (fECHO) and, often, before the examination by echocardiography performed by a cardiologista (cECHO). Objective: Compare the accuracy of echocardiography performed by a pediatrician (fECHO) and a cardiologist (cECHO) on neonatal and pediatric patients in an intensive care unit. Material and Methods: Retrospective analysis of the medical records of pediatric patients from zero days to 14 years, admitted to the intensive care unit, with a clinical indication for evaluation by comprehensive echocardiography of anatomical cardiac alterations were also evaluated through ecofunctional by a pediatrician. Results: Eight nine patients were admitted from zero days to 14 years, 55 of whom were male, and 34 were female. The respective sensitivity and specificity of fECHO and cECHO were 80% and 96.2% for the persistence of the ductus arteriosus; 88.4% and 98.4% for congenital acyanotic heart disease; 77.7% and 98.7% for congenital cyanotic heart disease; 83.3% and 98.8% for ventricular hypertrophy; 100% and 100% for pericardial effusion; 76.2% and 96.2% for persistent neonatal pulmonary hypertension. Conclusions: The results demonstrate a good accuracy of the pediatrician performing fECHO compared with a examination performed by the cardiologist, which does not reduce the importance and obligation of expert assessment. The incorporation of fECHO in the routine pediatric evaluation allows for the expansion and improvement of the pediatrician's physical examination.