Effective fluid management presents a significant challenge for pediatric intensivists. Enhanced ultrasound data that predict adverse outcomes, such as edema and venous congestion, can provide important information about optimal fluid management. The integration of bedside multiorgan ultrasound protocols (Multi-POCUS) mitigates the limitations of individual scoring systems, enabling more accurate fluid monitoring and management. The Tri-POCUS approach, described initially in adult patients, combines lung ultrasound, focused cardiac ultrasound, and venous excess ultrasound, and its application in the pediatric population is proposed. This study examines the Tri-POCUS approach from a pediatric perspective: we applied it to a cohort of critically ill pediatric patients with venous congestion admitted to a pediatric intensive care unit. Four cases are presented to demonstrate the bedside utility of the Tri-POCUS approach in critically ill children with the goal of monitoring venous congestion.

Keywords: Fluid overload; VExUS score; hepatic venous Doppler; inferior vena cava; intrarenal venous Doppler; pediatric intensive care unit; point of care ultrasound; portal venous Doppler; ultrasonography/heart; ultrasonography/lung; venous congestion; venous excess ultrasound.

Copyright: © 2025 Journal of Medical Ultrasound.

有效的液体管理对儿科重症医师来说是一个重大挑战。增强型超声数据，如预测不良结果的水肿和静脉淤血等指标，可以提供有关最佳液体管理的重要信息。床旁多器官超声协议（Multi-POCUS）的整合减轻了单一评分系统的局限性，使更准确的液体监测和管理成为可能。Tri-POCUS方法最初在成人患者中描述，结合肺部超声、心脏聚焦超声和静脉过剩超声，并建议将其应用于儿科人群。本研究从儿科视角考察了Tri-POCUS方法：我们将该方法应用于一组因静脉淤血而入住儿科重症监护病房的危重患儿队列。本文提出了四个病例，以展示在监测危重儿童静脉淤血时床旁使用Tri-POCUS方法的实用性。

关键词: 液体过载；VExUS评分；肝静脉多普勒；下腔静脉；肾内静脉多普勒；儿科重症监护病房；即时超声；门静脉多普勒；心脏超声；肺部超声；静脉淤血；静脉过剩超声。