scholarly journals Lung Ultrasound in the Neonatal Intensive Care Unit: Does It Impact Clinical Care?

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1098
Author(s):  
J. Lauren Ruoss ◽  
Catalina Bazacliu ◽  
Nicole Cacho ◽  
Daniele De Luca
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Clinical Care ◽  
Neonatal Intensive Care Units ◽  
Point Of Care Ultrasound ◽  
Predictive Tool ◽  
Neonatal Lung ◽  
Respiratory Conditions

A neonatal point-of-care ultrasound has multiple applications, but its use has been limited in neonatal intensive care units in the Unites States. An increasing body of evidence suggests that lung ultrasound performed by the neonatologist, at the bedside, is reliable and accurate in differentiating neonatal respiratory conditions, predicting morbidity, and guiding invasive interventions. Recent research has shown that a lung ultrasound can assist the clinician in accurately identifying and managing conditions such as respiratory distress syndrome, transient tachypnea of the newborn, and bronchopulmonary dysplasia. In this review, we discuss basic lung ultrasound terminology, evidence for applications of neonatal lung ultrasound, and its use as a diagnostic and predictive tool for common neonatal respiratory pathologies.

scholarly journals The role of lung ultrasound in preterm neonates with respiratory distress in neonatal intensive care unit

2021 ◽  
Vol 8 (8) ◽  
pp. 284-288
Author(s):  
Sidhant Swarup ◽  
Rakesh Panigrahi ◽  
Suryakanta Swain ◽  
Hemant Agrawal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Preterm Neonates ◽  
Point Of Care Ultrasound

Introduction: Up to 29% of late preterm babies suffer from respiratory distress due to which they need to be admitted to neonatal intensive care unit (NICU). Point-of-care ultrasound is a useful tool in critical neonate care, providing valuable information without any risk of ionizing radiation to the newborn. Materials and Method: This mono-centric, descriptive, and prospective study was conducted in NICU. Preterm newborns of less than 36 weeks with respiratory distress at birth on non-invasive ventilation were recruited. A lung ultrasound was performed at first 12 h of life and followed till their discharge. Main outcomes need for surfactant treatment. Results: Sixty preterm infants (median gestational age: 29 weeks) were recruited. Newborn in the surfactant group requiring ultrasound and intervention was significantly higher than in no surfactant group (p<0.0001). In 15 newborns who received surfactant, the first dose was administered at a median age of 4.5 h. In 13 of these 15 newborns, the lung ultrasound scan was subsequently repeated an average of 2 h (Standard deviation or SD: 2) On average, the second dose of surfactant was administered at 24 h of life (SD: 9). Conclusion: Early lung ultrasound in preterm infants with respiratory distress appears to be a useful tool with no adverse effects for the patient. It allows a better assessment of respiratory distress by detecting patients with a greater risk of requiring surfactant or mechanical ventilation, even before oxygenation criteria.

Role of Lung Ultrasound in the Diagnosis of Neonatal Respiratory Disorders

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nehal M El Raggal ◽  
laila A Hegazy ◽  
Hossam M Sakr ◽  
Yasmin A Farid ◽  
Osama A Eldafrawy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray

Abstract lung ultrasound (LUS) was used traditionally in the assessment of pleural effusions and masses but LUS has moved towards the imaging of the pulmonary parenchyma, mainly as a point-of-care technique. Objective To assess the agreement between LUS and CXR for the diagnosis of RD in neonates. Methods This prospective cross sectional study was conducted on 100 neonates presents with RD in the first 24 hours of life in the neonatal intensive care unit (NICU) of the Ain Shams University. All enrolled neonates underwent LUS and CXR initially and on day 7. Neonatologists were blind to the LUS diagnosis and the clinical decisions were driven by CXR findings. Lung score was applied to describe lung aeration, interstitial, alveolar, or consolidation patterns for each lung area. Results 125 different diagnoses were reported in 100 patients. The total agreement between LUS and CXR diagnosis was 96% (95% CI 88–98%) with a κ statistic of 0.94 (95% CI 0.86– 1.00). The agreement for RDS, Pneumonia, TTN, MAS, CDH, PE, Pnumothorax and atelectasis were 99%, 96%,98%, 99%,100%,100%,98% and 98% consequently. Conclusion LUS is a safe, low coast, easy to operate and has high agreement with CXR for the diagnosis of RD in neonates in the first week of life. Key words Neonatal intensive care, Point-of-care ultrasound, Chest X-ray Abbreviations: NICU: Neonatal Intensive Care Unit, LUS: Lung ultrasound, CXR: Chest X ray, RDS: respiratory distress syndrome, TTN: Transient Tachypnea of Newborn, MAS: Meconium Aspiration, PE: pleural effusion, CDH: cong. diaphragmatic hernia.

Survey of Point-of-Care Ultrasound Uptake in Indian Neonatal Intensive Care Units: Results and Recommendations

2019 ◽  
Vol 33 (1-4) ◽  
pp. 13-21
Author(s):  
Sujata Deshpande ◽  
Pradeep Suryawanshi ◽  
Neha Sharma ◽  
Rajesh Maheshwari ◽  
Rema Nagpal ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Neonatal Intensive Care Units ◽  
Point Of Care Ultrasound ◽  
Cranial Ultrasound ◽  
Prenatal Diagnostic ◽  
Trained Personnel ◽  
Point Of Care Ultrasonography

Objectives: Point-of-care ultrasonography (POCU) refers to the process of ultrasound performed at the bedside by treating physicians, for the ongoing assessment of disease, evaluation of response to treatment, and assistance in procedures. This study was conducted to assess the current utilization, training, and barriers to the implementation of neonatologist-performed POCU (NP-POCU) in Indian neonatal intensive care units (NICUs). Methods: A survey questionnaire was disseminated to practicing neonatologists in India via an online survey tool from July 2017 to September 2017. The questionnaire addressed the information related to the availability of NP-POCU services, indications for its use, perception among neonatologists about its usefulness, training for NP-POCU, and access to pediatric cardiology and radiology services. Results: The overall response rate was 78%. A total of 72% respondents reported having access to NP-POCU services in their units. Neonatologist-performed POCU (NP-POCU) was used most frequently for cranial ultrasound (97%), functional echocardiography (90%), and evaluating line position (67%). Majority (92%) of the units had no training program for NP-POCU. The most common reasons cited for not having NP-POCU services were non-availability of trained personnel to perform POCU (50%) and strict Pre-conception and Prenatal Diagnostic Techniques (PC-PNDT) Act (50%). Conclusions: Neonatologist-performed point-of-care ultrasonography is being increasingly utilized in Indian NICUs. However, there is a lack of structured training and guidelines for its use. Non-availability of trained personnel and strict PC-PNDT Act are major barriers to its implementation. We recommend that accredited training programs and standardized guidelines be established for the safer use of NP-POCU in India.

scholarly journals Merits and perils of targeted neonatal echocardiography-based hemodynamic research: a position statement

2019 ◽  
Vol 97 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Ashraf Kharrat ◽  
Patrick J. McNamara ◽  
Dany Weisz ◽  
Amish Jain
Keyword(s):  
Neonatal Intensive Care ◽  
Heart Function ◽  
Point Of Care ◽  
Position Statement ◽  
Neonatal Intensive Care Units ◽  
Point Of Care Ultrasound ◽  
First Time ◽  
Neonatal Echocardiography ◽  
Clinical Problems ◽  
Time Assessment

In the neonatal setting, point-of-care ultrasound is increasingly being used to help clinicians with the evaluation of heart function. Practices in neonatology, particularly with regard to acute and chronic hemodynamic managements, were traditionally more driven on dogma and predefined thresholds and not always supported by demonstrable physiology. For the first time, targeted neonatal echocardiography (TNE) provided neonatal intensivists with a bedside tool that made real-time assessment of neonatal hemodynamics status feasible in even the tiniest of babies. This opened the door towards more targeted physiological driven practices, allowing us to test historical approaches to clinical problems in a more precise way. Despite the standardization of TNE training and the creation of a formalized curriculum, little attention has been paid to the establishment of an empirical framework to adjudicate scientific investigation. In this position statement, we reflect on the evolution of TNE in Canadian neonatal intensive care units, appraise its strengths and limitations, and suggest guiding principles for clinicians and researchers to consider as they take this field forward.

Point-of-care ultrasound in the neonatal intensive care unit: international perspectives

2011 ◽  
Vol 16 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Nick Evans ◽  
Veronique Gournay ◽  
Fernando Cabanas ◽  
Martin Kluckow ◽  
Tina Leone ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
International Perspectives

Neonatal & Paediatric Point Of Care Ultrasound (Pocus): A Novel Standard Practice

2021 ◽  
Vol 8 (3) ◽  
pp. 124-131
Author(s):  
Dr. Abhijit Shinde ◽  
Dr. Sushrut Kumar ◽  
Dr. Sneha Mhaske
Keyword(s):  
Intensive Care ◽  
Endotracheal Tube ◽  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Developed Countries ◽  
Tube Placement ◽  
Point Of Care Ultrasound ◽  
Standard Practice ◽  
Endotracheal Tube Placement ◽  
Growing Body

An ever expanding branch of applications have been developed for ultrasound, including its goal directed use at the bedside, often called point-of-care ultrasound (POCUS). ).  Although neonatologist-performed functional echocardiography has been at the frontline of the worldwide growth of POCUS, a rapidly growing body of evidence has also demonstrated the importance of non-cardiac applications, including guidance of placement of central catheterisation and lumbar puncture, endotracheal tube localisation as well as rapid estimation of the brain, lungs, bladder and bowel.  Ultrasonography has become a pivotal adjunct to the care of neonates in the neonatal intensive care unit (NICU); but a full appreciation for its diagnostic capabilities in the NICU is lacking.(2) Ultrasonography (USG) is no longer the exclusive domain of radiologists and cardiologists. With appropriate training, clinician performed ultrasound (CPU) is now practised widely in obstetrics, emergency medicine and adult intensive care .In many developed countries,it is standard practice in neonatology. (3) In this review, we will discuss neonatal & pediatric point of care ultrasound (POCUS) as a novel standard practice & its clinical application for assessment of the head, heart, lung, gut, bladder, for vascular line localization & for endotracheal tube placement. As new applications and adoption of point-of-care ultrasound continues to gain acceptance in paediatric and neonatal medicine throughout the world, a rapidly growing body of evidence suggests that the result will be faster, safer and more successful diagnosis and treatment of our  patients.

Lung Ultrasound as a New Technique for Diagnosis of Neonatal Respiratory Diseases

2018 ◽  
Vol 37 (4) ◽  
pp. 224-232 ◽  
Author(s):  
Yasser N. Elsayed
Keyword(s):  
Lung Disease ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Ultrasound Images ◽  
X Ray ◽  
The Past ◽  
Neonatal Lung ◽  
Chest X Ray ◽  
A New Technique

Point-of-care ultrasound in the NICU is becoming more commonplace and is now used for a number of indications. Over the past ten years, the use of ultrasound as an alternative to a chest x-ray for the diagnosis of neonatal lung disease has been explored, and protocols were developed to refine the interpretation of ultrasound images in neonatal lung disease. The purpose of this column is to briefly explain the physics of ultrasound and describe the application of ultrasound to neonatal lung assessment.

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