(896) Bedside Bladder Scanner in Pediatric Critical Care

Introduction: Bedside bladder scanning in the PICU helps reduce unnecessary catheterizations, confirm urine stream blockage and conduct Trials Without Catheters (TWOC). Biocon devices have a simplified algorithm that can provide answers without additional sonographic training. However, simplifying their use comes at the cost of making certain delicate sonographic functions more workable.

Methods: In this review, we estimated the success rate of Biocon use in Pediatric Tertiary ICUs. When the bladder volume measured by Biocon didn’t match the clinical expectations (like palpation or previous response to diuretic use), a bedside Sonosite device—Point of Care Ultrasounds (POCUS)—was used.

Results: We examined 1134 occasions in retrospect. 564 (49.7%) were for TWOC, 394 (34.8%) were for reducing unnecessary catheterizations, and 176 (15.5%) were for confirming blockage. Success rate 443/564 (78.5%), 311/394 (78.9%), and 154/176 (87.5%) at p< 0.05.
The success rate 908/1134 (80%) is influenced by the age 324/442 (73.3%) for younger than three years old and 584/692 (84.4%) for older p< 0.05. The most common reason for failure was patient age (body size), edema, and ascites, accounting for 96 out of 108 cases (88.9%). In 56 occasions when the Biocon results were incompatible with the clinical expectation, POCUS was used with a success rate of 51/56 (91.1%).

Conclusions:

Conclusion: Bladder scanning with Biocon in the PICU is a simple and effective technique for reducing unnecessary catheterizations. Age (younger than three years old), edema, and ascites are the common reasons for failures. In parallel, Biocon utilization offers an introduction to ultrasounds by the bedside staff.