Translating Guidelines into Practical Practice: Point-of-Care Ultrasound for Pediatric Critical Care Clinicians.

Point-of-care ultrasound (POCUS) is now transitioning from an emerging technology to a standard of care for critically ill children. POCUS can provide immediate answers to clinical questions impacting management and outcomes within this fragile population. Recently published international guidelines specific to POCUS use in neonatal and pediatric critical care populations now complement previous Society of Critical Care Medicine guidelines. The authors review consensus statements within guidelines, identify important limitations to statements, and provide considerations for the successful implementation of POCUS in the pediatric critical care setting.

A narrative review of diaphragmatic ultrasound in pediatric critical care.

The use of point of care ultrasound (POCUS) at the bedside has increased dramatically within emergency medicine and in critical care. Applications of POCUS have spread to include diaphragmatic assessments in both adults and children. Diaphragm POCUS can be used to assess for diaphragm dysfunction (DD) and atrophy or to guide ventilator titration and weaning. Quantitative, semi-quantitative and qualitative measurements of diaphragm thickness, diaphragm excursion, and diaphragm thickening fraction provide objective data related to DD and atrophy. The potential for quick, noninvasive, and repeatable bedside diaphragm assessments has led to a growing amount of literature on diaphragm POCUS. To date, there are no reviews of the current state of diaphragm POCUS in pediatric critical care. The aims of this narrative review are to summarize the current literature regarding techniques, reference values, applications, and future innovations of diaphragm POCUS in critically ill children. A summary of current practice and future directions will be discussed.