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Implementing point of care ultrasound in the neonatal intensive care unit: a safety study

Abstract

Objective

Point of care ultrasound (POCUS) use is increasing in pediatrics and has been demonstrated to be superior in identifying central catheter tip location in neonatal intensive care units. However, limited data exist regarding cardiorespiratory changes secondary to POCUS in neonates.

Study design

A prospective observational equivalence study was performed on 50 POCUS assessments of central catheter tip location in 46 patients ≥23 weeks gestation. Heart rate (HR), respiratory rate (RR), and percent oxygen saturation (SpO2) levels were collected before and after POCUS. Limits of equivalence were set in advance.

Result

Equivalence was demonstrated in HR, RR, and SpO2 before and after POCUS. HR decreased by 3.24 beats per minute (90% CI: −5.36, −1.14). RR increased by 0.71 breath/min (90% CI: −1.84, +3.27). SpO2 increased by 0.54 percentage points (90% CI: −0.23, +1.31).

Conclusion

Identifying central catheter tip location using POCUS in neonates appears safe without affecting cardiorespiratory stability.

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Fig. 1: Plots for heart rate in beats per minute (top left), respiratory rate in breaths per minute (top right), and percent oxygen saturation (SpO2) in percentage points (bottom center).

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Funding

UnityPoint Health-Meriter Foundation provided grant money for this project.

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Authors

Contributions

EC designed the study, helped to acquire and interpret data, helped to write and revise the manuscript, and contributed to final approval of the version to be published. RM helped to design the study, helped to collect and interpret data, helped to write and revise the manuscript, and contributed to final approval of the version to be published. ML helped to design the study, analyzed and interpreted the data, helped to write and revise the manuscript, and contributed to final approval of the version to be published. AA helped to design the study, helped to write and revise the manuscript, and contributed to final approval of the version to be published. AB helped to design the study, helped to collect and interpret data, helped to write and revise the manuscript, and contributed to final approval of the version to be published.

Corresponding author

Correspondence to Eileen Cowan.

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The authors declare no competing interest.

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Cowan, E., Meinen, R.D., Lasarev, M.R. et al. Implementing point of care ultrasound in the neonatal intensive care unit: a safety study. J Perinatol 41, 879–884 (2021). https://doi.org/10.1038/s41372-021-00955-5

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