Ultrasound in the Neonatal Intensive Care Unit

Mirza, Hussnain; Logsdon, Gregory; Padbury, Jamés F.

doi:10.1007/978-1-4939-1723-5_16

Cited by 2 publications

(9 citation statements)

References 26 publications

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“…Common complications include phlebitis, catheter malposition or migration, catheter occlusion, catheter-related bloodstream infections, leakage (such as pleural effusion), and pneumothorax. 1,3,6,12 In this study, three cases of complications (leakage, infection, and phlebitis) occurred, but all of these patients recovered rapidly after the removal of the catheter. In regard to the early detection and diagnosis of complications, ultrasound has advantages over X-ray due to complications, such as pneumothorax, pleural effusion, and catheter malposition or migration, which can be identified faster and more accurately under ultrasound.…”

Section: Discussionmentioning

confidence: 62%

“…Ultrasonic localization is safer, more accurate, and more advantageous than X-ray and can identify instances of malpositioning that X-ray radiography cannot detect. 1,2,[4][5][6]9 Ultrasound enables real-time assessment, facilitates catheter repositioning, and obviates X-ray exposure. Our findings confirmed the accuracy and consistency of ultrasonic identification of the PICC tip; the catheter was successfully placed on the first attempt in 93.5% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…11 This procedure is the gold standard in PICC tip ultrasonic localization and is especially useful for trainees. 6 After trainees have learned the technique and skill, this step can be skipped.…”

Section: Discussionmentioning

confidence: 99%

“…The optimal position was at the cavoatrial junction. 6 The position of the catheter tip could be further confirmed by injecting saline or other fluids under ultrasound; the fluid could be observed rapidly flowing out of the catheter tip. The correct placement of the catheter could be determined by measuring the distance between the catheter tip and the right atrium entrance.…”

Section: Ultrasonic Localizationmentioning

confidence: 99%

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Ultrasound to Localize the Peripherally Inserted Central Catheter Tip Position in Newborn Infants

Ren

Chen

et al. 2019

Am J Perinatol

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Objective To evaluate the application of ultrasound for the localization of the tip position of peripherally inserted central catheters (PICCs) in newborn infants. Study Design This study was a retrospective analysis on ultrasonic localization for PICC placement conducted in our department over the past 2 years. Ultrasonic localization was performed immediately after PICC placement in all neonatal patients. Successful PICC placement was confirmed if the PICC tip position was located at the inferior/superior cavoatrial junction. Chest X-ray localization was performed on 32 infants immediately after ultrasound examination to compare the accuracy of ultrasound localization. Results Of the 186 patients, 174 (93.5%) had successful PICC placement on the first attempt. In 11 (5.9%) patients, the catheter tip was placed beyond the ideal location as follows: too deep (in the right atrium) in 4 patients, too shallow in 4 patients, and malpositioned in 3 patients. Both the sensitivity and the specificity of ultrasound for identifying PICC tip localization were 100%. Complications occurred in 2.7% of this group of patients. Conclusion Ultrasonic localization of the PICC tip position is a timely, accurate, and reliable method and can identify the catheter tip with high accuracy. This method could be widely applied in neonatal wards.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Ultrasonic Localizationmentioning

confidence: 99%

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Ultrasound to Localize the Peripherally Inserted Central Catheter Tip Position in Newborn Infants

Ren

Chen

et al. 2019

Am J Perinatol

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“…Yet, retrospective study of 468 litigation cases revealed that no neonatologist was sued for using and interpreting POC US. 15 Relatively recently, Mirza et al 16 proposed a neonatal POC US training program model. This model includes description and recommendations for several NICU applications.…”

mentioning

confidence: 99%

Structured Neonatal Point-of-Care Ultrasound Training Program

et al. 2020

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Objective Point-of-care ultrasound (POC US) has been increasingly used by intensive care physicians. Growing use of POC US necessitates defining distinct clinical indications for its application, as well as structured POC US training programs. Homogeneous approach to POC US education combined with rigorous quality assurance should further enable POC US to become standard-of-care clinical tool. This study aimed to present the first, innovative, and structured POC US program in neonatal–perinatal medicine field. In addition, we reviewed the availability of the POC US training programs across different medical specialties. Study Design Available English-language publications on POC US training programs in general and neonatal–perinatal medicine were reviewed in this study. Discussion Mounting body of evidence suggests improved procedural completion rates, as well as clinical decision making with the use of POC US. However, limited research supported the existence of structured, comprehensive POC US programs. It was recognized that medical institutions need to develop syllabuses, teach, and credential increasing number of health care professionals in the use of POC US. We defined intuitive educational strategy that encompasses POC US clinical indications, educational curriculum, scanning protocols, competence evaluation, and finally credentialing process. In addition, we offered description of the imaging quality assurance, as well as POC US coding, and reimbursement. Conclusion Future efforts need to be dedicated to the ongoing development of neonatal POC US as a clinical instrument. It should allow for eventual paradigm change and improved effectiveness in management of critically ill neonates.

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Ultrasound in the Neonatal Intensive Care Unit

Cited by 2 publications

References 26 publications

Ultrasound to Localize the Peripherally Inserted Central Catheter Tip Position in Newborn Infants

Ultrasound to Localize the Peripherally Inserted Central Catheter Tip Position in Newborn Infants

Structured Neonatal Point-of-Care Ultrasound Training Program

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