Introduction
Right ventricle (RV) dysfunction has a significant impact on the
morbidity and mortality of critically ill patients; it is common in
acute respiratory failure and is associated with worse outcomes (1).
However, its routine assessment is not yet widely practiced in
pediatrics.
Echocardiography is a non-invasive and widely available tool that can
provide real-time hemodynamic information, assess cardiac function, load
conditions and cardiac output (2). The echocardiographic evaluation of
the right ventricle is more challenging due to its retrosternal position
and complex geometric shape (3). There are several parameters to assess
RV function, each with strengths and limitations, but there is no
consensus in the literature regarding the definition of dysfunction and
the methods used for its evaluation (4).
It is known that mechanical ventilation leads to increased intrathoracic
pressures and interferes with the pulmonary vascular circulation,
impacting RV load. In adults, RV dysfunction has been found to be
prevalent even when subjected to protective ventilation strategies
(5).
As there is a lack of literature on this topic in pediatrics, the
present study aims to assess the prevalence of right ventricle
dysfunction in children undergoing mechanical ventilation through
bedside echocardiography. Additionally, the study seeks to investigate
any associations with respiratory and pulmonary mechanical parameters,
cardiac index, and the presence of shock.