Authors
Robert M Hoffmann, Nathan Georgette, Matthew A Eisenberg, Jeffrey T Neal, Cynthia A Gravel, Elaine Chiang, Jason A Levy, Michael C Monuteaux, Andrew F Miller
Published in
Pediatric emergency care. Jul 14, 2026. Epub Jul 14, 2026.
Abstract
To evaluate whether reduced ventricular function identified by cardiac point-of-care ultrasound (POCUS) in children with suspected systemic infection is associated with subsequent use of IV vasoactive medications.
We conducted a retrospective cohort study of patients aged 1 month to 21 years presenting to a tertiary pediatric emergency department (ED) between 2015 and 2024. Eligible patients underwent cardiac POCUS performed by the clinical team before vasoactive therapy (if any) and received evaluation and treatment for suspected systemic infection. Global ventricular function was categorized as reduced or not reduced based on image review by an expert sonographer. Multivariable logistic regression assessed associations between reduced function and clinical outcomes.
Of 329 included patients, 27 (8.2%) had reduced cardiac function on POCUS, and 55 (16.7%) subsequently received an IV vasoactive. Reduced function was associated with higher odds of IV vasoactive use (aOR=7.9, 95% CI: 2.7-23.0), ICU admission, and fewer ICU- and hospital-free days. Interrater agreement between bedside and expert interpretation was excellent (κ=0.90). Associations remained consistent in secondary analyses using expert interpretations.
Cardiac POCUS findings of reduced ventricular function were strongly associated with subsequent IV vasoactive therapy and worse clinical outcomes. These findings suggest that reduced cardiac function identified on cardiac POCUS is associated with greater illness severity and may support early risk stratification.
PMID:
42444168
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.
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