The Use of Point‐of‐Care Ultrasound to Evaluate Pulsus Paradoxus in Children With Asthma

• Published in: Journal of ultrasound in medicine Vol. 39; no. 3; pp. 625 - 632
• Main Authors: Kharasch, Sigmund J., Jansson, Paul, Liteplo, Andrew S., Gouker, Stacey, Longacre, McKenna, Shokoohi, Hamid, Schleifer, Jessica
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-03-2020
• Subjects: Adolescent; Asthma - physiopathology; Blood Pressure - physiology; Child; Child, Preschool; Echocardiography, Doppler - instrumentation; Echocardiography, Doppler - methods; Female; Heart - diagnostic imaging; Heart - physiopathology; Humans; Male; Point-of-Care Systems; point‐of‐care ultrasound; pulsed wave Doppler; pulsus paradoxus; Severity of Illness Index; ultrasound; pulsus paradoxus; pulsed wave Doppler; point-of-care ultrasound; ultrasound
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.15226

Pulsus paradoxus (PP) is defined as a fall of systolic blood pressure of greater than 10 mm Hg during the inspiratory phase of respiration. Measurement of PP is recommended by national and international asthma guidelines as an objective measure of asthma severity but is rarely used in clinical practice. Cardiac point‐of‐care ultrasound with pulsed wave Doppler imaging measuring respiratory‐phasic changes of mitral valve inflow velocities is well described in cardiac tamponade as “sonographic” PP. We present 10 cases of acute asthma presenting to an emergency department showing the finding of sonographic determined PP in the apical 4‐chamber view of the heart on pulsed wave Doppler imaging.