El Quinto Elemento del Examen Físico Moderno: Ecografía Crítica Pediátrica

CRITICAL CARE & EMERGENGY MEDICINE VOL. 5

The Fifth Element of the Modern Physical Examination: Critical Pediatric Ultrasound

Enviar Artículo

www.doi.org/10.58281/ccem060126-rev-nar-09

Javier Ponce 1 , Reynaldo Carvajal Choque 2 , David Pascual Rojas Flores 3 , Joaquín Martínez Rivero 4 , Edwin Mauricio Cantillano Quintero 5 , María Lellis Figueroa Russo 6 , Patrick Danny Caqui Vilca 7 , Eduardo Tomás Alvarado 8 , Daniela Vallejos 9 , Cecilia Judith Taboada Palomino 10 .

1 Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.
2 Hospital Petrolero La Paz, Bolivia. Miembro fundador USPed Latinoamérica.
3 Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México. Miembro fundador USPed Latinoamérica.
4 Asociación Venezolana de Ultrasonido en Medicina (AVUM). Venezuela. Miembro fundador USPed Latinoamérica.
5 Hospital Regional del Norte, Instituto Hondureño Seguridad Social, San Pedro Sula, Honduras. Miembro fundador USPed Latinoamérica.
6 Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.
7 Instituto Nacional de Salud del Niño San Borja, Perú. Miembro fundador USPed Latinoamérica.
8 Hospital General Regional 17, Instituto Mexicano del Seguro Social, Quintana Roo, México. Miembro fundador USPed Latinoamérica.
9 Hospital General de Niños Pedro Elizalde, Hospital Garrahan, Argentina. Miembro fundador USPed Latinoamérica.
10 Hospital Regional Docente de Trujillo. Perú. Miembro fundador USPed Latinoamérica.
Miembros fundadores USPed Latinoamérica.

Editor
Diego Escarraman Martinez , Jorge M Antolinez-Motta .

Chair
Gerardo Alberto Solis Perez .

Abstract

Abstract: The use of bedside ultrasound (POCUS) has generated a paradigm shift in pediatric medical care, allowing immediate visualization and interpretation of images. This tool has gained widespread acceptance among pediatricians, improving the accuracy and safety of various assessments and procedures.
Recent guidelines from the American Heart Association and the European Society of Pediatric and Neonatal Intensive Care have defined recommendations and training standards for pediatric and neonatal POCUS, including cardiac, pulmonary, vascular, cerebral, and abdominal applications.
These guidelines constitute a framework for its clinical application and the development of training programs for physicians and other healthcare professionals, and it has become the fifth element of the physical examination. This narrative review summarizes and describes the current application and prospects of this tool with regard to artificial intelligence and new technologies related to critical ultrasound

Resumen:  La utilización del modelo de ecografía en la cama del niño enfermo, POCUS por sus siglas en inglés (Point of Care Ultrasound)
ha generado un cambio de paradigma en la atención médica pediátrica, permitiendo una visualización e interpretación inmediata de imágenes de manera inmediata. Esta herramienta, se ha posicionado con buena aceptación entre los pediatras, mejorando la precisión y seguridad en la ejecución de diferentes valoraciones y procedimientos. Guías recientes de la American Heart Association y la Sociedad Europea de Terapia Intensiva Pediátrica y Neonatal han definido recomendaciones y estándares de entrenamiento en POCUS pediátrico y neonatal, incluyendo aplicaciones cardíacas, pulmonares, vasculares, cerebrales y abdominales. Estas pautas constituyen un marco para su aplicación clínica y desarrollo de programas de formación para médicos y otros profesionales de la salud y se ha convertido en el quinto elemento de el examen físico. En esta revisión narrativa se resume y describe la aplicación actual y perspectivas de esta herramienta en lo que respecta a inteligencia artificial y nuevas tecnologías relacionadas con la ecografía crítica.

Point-of-Care Ultrasound, Pediatric Intensive Care Units, patient safety.

Javier Ponce.
Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.

Reynaldo Carvajal Choque.
Hospital Petrolero La Paz, Bolivia. Miembro fundador USPed Latinoamérica.

David Pascual Rojas Flores.
Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México. Miembro fundador USPed Latinoamérica.

Joaquín Martínez Rivero.
Asociación Venezolana de Ultrasonido en Medicina (AVUM). Venezuela. Miembro fundador USPed Latinoamérica.

Edwin Mauricio Cantillano Quintero.
Hospital Regional del Norte, Instituto Hondureño Seguridad Social, San Pedro Sula, Honduras. Miembro fundador USPed Latinoamérica.

María Lellis Figueroa Russo.
Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.

Patrick Danny Caqui Vilca
Instituto Nacional de Salud del Niño San Borja, Perú. Miembro fundador USPed Latinoamérica.

Eduardo Tomás Alvarado.
Hospital General Regional 17, Instituto Mexicano del Seguro Social, Quintana Roo, México. Miembro fundador USPed Latinoamérica.

Daniela Vallejos.
Hospital General de Niños Pedro Elizalde, Hospital Garrahan, Argentina. Miembro fundador USPed Latinoamérica.

Cecilia Judith Taboada Palomino.
Hospital Regional Docente de Trujillo. Perú. Miembro fundador USPed Latinoamérica.
Miembros fundadores USPed Latinoamérica.

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[1] Javier Ponce, Reynaldo Carvajal Choque, David Pascual Rojas Flores, Joaquín Martínez Rivero, Edwin Mauricio Cantillano Quintero, María Lellis Figueroa Russo, Patrick Danny Caqui Vilca, Eduardo Tomás Alvarado, Daniela Vallejos, and Cecilia Judith Taboada Palomino. 2026. El quinto elemento del examen físico moderno: ecografía crítica pediátrica. CRITICAL CARE & EMERGENGY MEDICINE 5, (January 2026), 18–32. https://doi.org/10.58281/ccem060126-rev-nar-09

Video 1. Pulmón normal vs Neumotórax. En el pulmón derecho se logra visualizar deslizamiento pleural e imagen de playa en modo M. En el pulmón izquierdo, pleura sin movimiento y código de barras en modo M.

Video 2. Ventrículo izquierdo. A: Fracción de acortamiento normal. B: Fracción de acortamiento disminuida

Video 3. Intubación esofágica. Nótese la aparición de la doble bala de cañón (*) al ingresar el tubo endotraqueal al esófago.

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2992-6785

eISSN: 2992-6785
DOI: 10.3989/ccem

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Patrocinadores

www.doi.org/10.58281/ccem060126-rev-nar-09

Javier Ponce 1 , Reynaldo Carvajal Choque 2 , David Pascual Rojas Flores 3 , Joaquín Martínez Rivero 4 , Edwin Mauricio Cantillano Quintero 5 , María Lellis Figueroa Russo 6 , Patrick Danny Caqui Vilca 7 , Eduardo Tomás Alvarado 8 , Daniela Vallejos 9 , Cecilia Judith Taboada Palomino 10 .

1 Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.
2 Hospital Petrolero La Paz, Bolivia. Miembro fundador USPed Latinoamérica.
3 Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México. Miembro fundador USPed Latinoamérica.
4 Asociación Venezolana de Ultrasonido en Medicina (AVUM). Venezuela. Miembro fundador USPed Latinoamérica.
5 Hospital Regional del Norte, Instituto Hondureño Seguridad Social, San Pedro Sula, Honduras. Miembro fundador USPed Latinoamérica.
6 Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.
7 Instituto Nacional de Salud del Niño San Borja, Perú. Miembro fundador USPed Latinoamérica.
8 Hospital General Regional 17, Instituto Mexicano del Seguro Social, Quintana Roo, México. Miembro fundador USPed Latinoamérica.
9 Hospital General de Niños Pedro Elizalde, Hospital Garrahan, Argentina. Miembro fundador USPed Latinoamérica.
10 Hospital Regional Docente de Trujillo. Perú. Miembro fundador USPed Latinoamérica.
Miembros fundadores USPed Latinoamérica.

Editor
Diego Escarraman Martinez , Jorge M Antolinez-Motta .

Chair
Gerardo Alberto Solis Perez .

Abstract

Abstract: The use of bedside ultrasound (POCUS) has generated a paradigm shift in pediatric medical care, allowing immediate visualization and interpretation of images. This tool has gained widespread acceptance among pediatricians, improving the accuracy and safety of various assessments and procedures.
Recent guidelines from the American Heart Association and the European Society of Pediatric and Neonatal Intensive Care have defined recommendations and training standards for pediatric and neonatal POCUS, including cardiac, pulmonary, vascular, cerebral, and abdominal applications.
These guidelines constitute a framework for its clinical application and the development of training programs for physicians and other healthcare professionals, and it has become the fifth element of the physical examination. This narrative review summarizes and describes the current application and prospects of this tool with regard to artificial intelligence and new technologies related to critical ultrasound

Resumen:  La utilización del modelo de ecografía en la cama del niño enfermo, POCUS por sus siglas en inglés (Point of Care Ultrasound)
ha generado un cambio de paradigma en la atención médica pediátrica, permitiendo una visualización e interpretación inmediata de imágenes de manera inmediata. Esta herramienta, se ha posicionado con buena aceptación entre los pediatras, mejorando la precisión y seguridad en la ejecución de diferentes valoraciones y procedimientos. Guías recientes de la American Heart Association y la Sociedad Europea de Terapia Intensiva Pediátrica y Neonatal han definido recomendaciones y estándares de entrenamiento en POCUS pediátrico y neonatal, incluyendo aplicaciones cardíacas, pulmonares, vasculares, cerebrales y abdominales. Estas pautas constituyen un marco para su aplicación clínica y desarrollo de programas de formación para médicos y otros profesionales de la salud y se ha convertido en el quinto elemento de el examen físico. En esta revisión narrativa se resume y describe la aplicación actual y perspectivas de esta herramienta en lo que respecta a inteligencia artificial y nuevas tecnologías relacionadas con la ecografía crítica.

Point-of-Care Ultrasound, Pediatric Intensive Care Units, patient safety.

Javier Ponce.
Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.

Reynaldo Carvajal Choque.
Hospital Petrolero La Paz, Bolivia. Miembro fundador USPed Latinoamérica.

David Pascual Rojas Flores.
Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México. Miembro fundador USPed Latinoamérica.

Joaquín Martínez Rivero.
Asociación Venezolana de Ultrasonido en Medicina (AVUM). Venezuela. Miembro fundador USPed Latinoamérica.

Edwin Mauricio Cantillano Quintero.
Hospital Regional del Norte, Instituto Hondureño Seguridad Social, San Pedro Sula, Honduras. Miembro fundador USPed Latinoamérica.

María Lellis Figueroa Russo.
Hospital Dr. Guillermo Rawson, San Juan, Argentina. Miembro fundador USPed Latinoamérica.

Patrick Danny Caqui Vilca
Instituto Nacional de Salud del Niño San Borja, Perú. Miembro fundador USPed Latinoamérica.

Eduardo Tomás Alvarado.
Hospital General Regional 17, Instituto Mexicano del Seguro Social, Quintana Roo, México. Miembro fundador USPed Latinoamérica.

Daniela Vallejos.
Hospital General de Niños Pedro Elizalde, Hospital Garrahan, Argentina. Miembro fundador USPed Latinoamérica.

Cecilia Judith Taboada Palomino.
Hospital Regional Docente de Trujillo. Perú. Miembro fundador USPed Latinoamérica.
Miembros fundadores USPed Latinoamérica.

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[1] Javier Ponce, Reynaldo Carvajal Choque, David Pascual Rojas Flores, Joaquín Martínez Rivero, Edwin Mauricio Cantillano Quintero, María Lellis Figueroa Russo, Patrick Danny Caqui Vilca, Eduardo Tomás Alvarado, Daniela Vallejos, and Cecilia Judith Taboada Palomino. 2026. El quinto elemento del examen físico moderno: ecografía crítica pediátrica. CRITICAL CARE & EMERGENGY MEDICINE 5, (January 2026), 18–32. https://doi.org/10.58281/ccem060126-rev-nar-09

Video 1. Pulmón normal vs Neumotórax. En el pulmón derecho se logra visualizar deslizamiento pleural e imagen de playa en modo M. En el pulmón izquierdo, pleura sin movimiento y código de barras en modo M.

Video 2. Ventrículo izquierdo. A: Fracción de acortamiento normal. B: Fracción de acortamiento disminuida

Video 3. Intubación esofágica. Nótese la aparición de la doble bala de cañón (*) al ingresar el tubo endotraqueal al esófago.

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DOI: 10.3989/ccem

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