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

J Ultrasound Med. 2020 Mar;39(3):625-632. doi: 10.1002/jum.15226. Epub 2020 Jan 23.

Abstract

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.

Keywords: point-of-care ultrasound; pulsed wave Doppler; pulsus paradoxus; ultrasound.

Publication types

  • Case Reports

MeSH terms

  • 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*
  • Severity of Illness Index