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

Abstract

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.