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Focused Cardiac Ultrasound in the Pediatric Perioperative Setting

Boretsky, Karen R. MD*; Kantor, David B. MD, PhD; DiNardo, James A. MD*; Oren-Grinberg, Achikam MD

doi: 10.1213/ANE.0000000000004357
Cardiovascular and Thoracic Anesthesiology
Continuing Medical Education

Focused cardiac ultrasonography (FoCUS) has become an important diagnostic tool for acute care physicians. FoCUS allows real-time visualization of the heart and, in combination with the physical examination, acts as a hemodynamic monitor to manage patient care in acute situations. Most of the available perioperative literature has focused on adult patients. Little has been published on the perioperative application of FoCUS for pediatric patients. This article provides an overview of FoCUS used at the bedside by pediatric anesthesiologists. Variations in clinical applications, technical aspects, and interpretation of FoCUS findings in children are described. Discussion of training and competency is included. Barriers to implementation by pediatric intensivists and emergency medicine physicians include a lack of understanding of indications and training opportunities in pediatric FoCUS. It is likely that similar barriers exist in pediatric anesthesiology resulting in underutilization of FoCUS. The use of FoCUS in the pediatric operating room, however, may positively impact care of infants and children and should be encouraged.

From the *Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts

Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Published ahead of print 24 June 2019.

Accepted for publication June 24, 2019.

Funding: Institutional and/or departmental.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Karen R. Boretsky, MD, Department of Anesthesiology Critical Care and Pain Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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