Novel Technologies for Neonatal Care: The Case of Point-of-Care Lung Ultrasonography

Abstract

* Abbreviations: CT — : computed tomography LUS — : lung ultrasound POCUS — : point-of-care ultrasound The introduction of a new technology into clinical practice is a slow process that includes research, training practitioners, and assessing its gradual diffusion into practice. Point-of-care ultrasound (POCUS) is currently 1 such technology in neonatology. Historically, in pediatrics, ultrasound use has been limited to cardiologists and radiologists. More recently, other pediatric acute care disciplines including pediatric critical care, emergency medicine, anesthesiology, and neonatology have used bedside ultrasound with increasing frequency in procedural and diagnostic applications. The value of POCUS for interventional applications and real-time longitudinal physiologic assessment of sick neonates has been recognized for many years. Despite these benefits, a recent survey revealed that less than one-third of the US Neonatal-Perinatal Medicine programs use bedside ultrasound for diagnostic and management decisions.1 The use of ultrasound to evaluate the pediatric patient’s lungs is relatively new and a potentially revolutionary approach. Over the past 2 decades there have been accumulating data, which allow radiologists and bedside providers to understand the value and the limitations of this imaging modality. Lung ultrasound (LUS) signs (eg, A-lines, B-lines, lung-sliding, etc) are the same among neonatal, pediatric, and adult patients. Among neonates, changes in the presence and absence of these signs occur rapidly after birth. It is only recently that these changes have been … Address correspondence to Scott A. Lorch, MD, MSCE, The Children’s Hospital of Philadelphia, 2716 South St, Room 10-251, Philadelphia, PA 19146. E-mail: lorch{at}email.chop.edu