Point-of-Care Ultrasound – in Pediatric

POCUS (Point-of-Care Ultrasound) as described in an earlier article (Point-of-Care Ultrasound in Neurology/16 Feb 2023) becomes more and more of importance also in other medical departments than Neurology. In 2022, a Taiwanese Working Group published an article, in which a consensus protocol was presented (Jainn-Jim Lin et al*).

Over the last decades, the benefits of TCD vs imaging modalities such as CT scan, MRI, … have been well known and more and more appreciated nowadays. ​The authors in this study point out the portability and flexibility of TCD as predestined for bed-side applications and thus meeting the concept of POCUS. Moreover, the authors also highlight the fact that TCD may be more useful in daily practice for identification of a more immediate, non-invasive bedside approach to complement these methods.​ Therefore, they see the importance of POCUS in a day-to-day bedside assessment of cerebral hemodynamic status in neurocritical care practice, including post cardiac arrest care.

In its conclusion, the study presented suggestions that the transcranial point-of-care Doppler ultrasound group was associated with significantly better 1-month survival in pediatric out-of-hospital cardiac arrests compared with the no transcranial point-of-care Doppler ultrasound group.

Transcranial Doppler sonography (TCD) is the gold standard to assess blood flow velocities in the vessels of the Circle of Willis in SCD patients and predict the risk of stroke. TCD is highly recommended as a routine screening tool not only for Sickle Cell Disease diagnostics, but also for prognosis and for guiding therapy and treatment: exchange transfusions, hydroxyurea, allogeneic hematopoietic stem cell transplant, recently approved drugs and new therapeutic options (gene therapy, gene editing).
During an examination with the TCD, the user is given the opportunity to display the highest blood flow velocities and therefore determine the SCD quickly and easily.