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.