Point-of-Care Ultrasound (POCUS) in Pediatric Age: Update

The implementation of point-of-care ultrasound (POCUS) has been a profound transformation in clinical practice, especially in the areas of emergency medicine and intensive care. It has emerged in recent years, particularly by borrowing in the pediatric setting the experience gained in the adult setting. POCUS ultrasound used at the patient’s bedside is useful both for diagnosing some common pathologies and for performing therapeutic procedures (chest drainage, central and peripheral vascular cannulation). The use of POCUS ultrasonography by pediatric intensivists has increased significantly and equally, both in Western countries (high-cost, high-tech intensive care providers) and in poorer countries in which the costs of intensive care are not fully supported by state budgets. Particularly in the pediatric age, this technology has found wide application in the diagnosis and monitoring of respiratory infections and in the monitoring of chronic and acute pulmonary pathology, allowing less radiological exposure to growing children and thus reducing oncological risks. A number of national and international societies have therefore been engaged in discussions in order to draft shared guidelines on both clinical application and regulation of operator training [1–7]. However, no unified guidelines are currently available for the pediatric and neonatal part, as it is at present for the adult part. The first POCUS application in neonatal and pediatric settings was goal-directed echocardiography. An expert statement was published in 2011, followed by the UK consensus statement on neonatologist-performed echocardiography and recommendations for European training [8–10]. The Australian Clinician Performed Ultrasound (CPU) program represents a well-established academic curriculum developed to train neonatologists limited to cerebral and cardiac assessment [10, 11]. Recently ESPNIC (European Society for Paediatric and Neonatal Intensive Care) published evidence-based guidelines drafted by an international panelist to define the use and applications of POCUS ultrasound in the pediatric setting, applicable by any professional who is involved in routine or urgent work with the critical child.