The Pediatric Tri-POCUS Approach: Conceptual Review and Case Series

Effective fluid management presents a significant challenge for pediatric intensivists. Enhanced ultrasound data that predict adverse outcomes, such as edema and venous congestion, can provide important information about optimal fluid management. The integration of bedside multiorgan ultrasound prot...

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Main Authors: Daniel Palanca Arias, Marcos Clavero Adell, Victoria Estabén Boldova, José Enrique Alonso Formento, Ariada Ayerza Casas, Almudena Alonso Ojembarrena
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Journal of Medical Ultrasound
Subjects:
Online Access:https://journals.lww.com/10.4103/jmu.JMU-D-24-00002
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author Daniel Palanca Arias
Marcos Clavero Adell
Victoria Estabén Boldova
José Enrique Alonso Formento
Ariada Ayerza Casas
Almudena Alonso Ojembarrena
author_facet Daniel Palanca Arias
Marcos Clavero Adell
Victoria Estabén Boldova
José Enrique Alonso Formento
Ariada Ayerza Casas
Almudena Alonso Ojembarrena
author_sort Daniel Palanca Arias
collection DOAJ
description Effective fluid management presents a significant challenge for pediatric intensivists. Enhanced ultrasound data that predict adverse outcomes, such as edema and venous congestion, can provide important information about optimal fluid management. The integration of bedside multiorgan ultrasound protocols (Multi-POCUS) mitigates the limitations of individual scoring systems, enabling more accurate fluid monitoring and management. The Tri-POCUS approach, described initially in adult patients, combines lung ultrasound, focused cardiac ultrasound, and venous excess ultrasound, and its application in the pediatric population is proposed. This study examines the Tri-POCUS approach from a pediatric perspective: we applied it to a cohort of critically ill pediatric patients with venous congestion admitted to a pediatric intensive care unit. Four cases are presented to demonstrate the bedside utility of the Tri-POCUS approach in critically ill children with the goal of monitoring venous congestion.
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publishDate 2025-04-01
publisher Wolters Kluwer Medknow Publications
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series Journal of Medical Ultrasound
spelling doaj-art-9adfbadaffa84c35900df82ef33d0e052025-08-20T03:07:50ZengWolters Kluwer Medknow PublicationsJournal of Medical Ultrasound0929-64412212-15522025-04-0133215416110.4103/jmu.JMU-D-24-00002The Pediatric Tri-POCUS Approach: Conceptual Review and Case SeriesDaniel Palanca AriasMarcos Clavero AdellVictoria Estabén BoldovaJosé Enrique Alonso FormentoAriada Ayerza CasasAlmudena Alonso OjembarrenaEffective fluid management presents a significant challenge for pediatric intensivists. Enhanced ultrasound data that predict adverse outcomes, such as edema and venous congestion, can provide important information about optimal fluid management. The integration of bedside multiorgan ultrasound protocols (Multi-POCUS) mitigates the limitations of individual scoring systems, enabling more accurate fluid monitoring and management. The Tri-POCUS approach, described initially in adult patients, combines lung ultrasound, focused cardiac ultrasound, and venous excess ultrasound, and its application in the pediatric population is proposed. This study examines the Tri-POCUS approach from a pediatric perspective: we applied it to a cohort of critically ill pediatric patients with venous congestion admitted to a pediatric intensive care unit. Four cases are presented to demonstrate the bedside utility of the Tri-POCUS approach in critically ill children with the goal of monitoring venous congestion.https://journals.lww.com/10.4103/jmu.JMU-D-24-00002fluid overloadhepatic venous dopplerinferior vena cavaintrarenal venous dopplerpediatric intensive care unitpoint of care ultrasoundportal venous dopplerultrasonography/heartultrasonography/lungvenous congestionvenous excess ultrasoundvexus score
spellingShingle Daniel Palanca Arias
Marcos Clavero Adell
Victoria Estabén Boldova
José Enrique Alonso Formento
Ariada Ayerza Casas
Almudena Alonso Ojembarrena
The Pediatric Tri-POCUS Approach: Conceptual Review and Case Series
Journal of Medical Ultrasound
fluid overload
hepatic venous doppler
inferior vena cava
intrarenal venous doppler
pediatric intensive care unit
point of care ultrasound
portal venous doppler
ultrasonography/heart
ultrasonography/lung
venous congestion
venous excess ultrasound
vexus score
title The Pediatric Tri-POCUS Approach: Conceptual Review and Case Series
title_full The Pediatric Tri-POCUS Approach: Conceptual Review and Case Series
title_fullStr The Pediatric Tri-POCUS Approach: Conceptual Review and Case Series
title_full_unstemmed The Pediatric Tri-POCUS Approach: Conceptual Review and Case Series
title_short The Pediatric Tri-POCUS Approach: Conceptual Review and Case Series
title_sort pediatric tri pocus approach conceptual review and case series
topic fluid overload
hepatic venous doppler
inferior vena cava
intrarenal venous doppler
pediatric intensive care unit
point of care ultrasound
portal venous doppler
ultrasonography/heart
ultrasonography/lung
venous congestion
venous excess ultrasound
vexus score
url https://journals.lww.com/10.4103/jmu.JMU-D-24-00002
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