Use of point of care bowel ultrasound (BUS) for diagnosis of suspected necrotizing enterocolitis (NEC): A feasibility study.

IF 1.4 Q3 CRITICAL CARE MEDICINE
Amitava Sur, Namitha Gopinathansarasa
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引用次数: 0

Abstract

Necrotizing enterocolitis (NEC) is a potentially fatal comorbidity of prematurity with one in five affected requiring surgical intervention. Despite its seriousness, there is lack of objective radiographic criteria on plain abdomnial radiographs (X-ray) to guide prognosis and decision making. Point of care bowel ultrasound (BUS) provides a more dynamic assessment and more information around bowel health. However, there is lack of widespread adoption of this practice by neonatologists due to training opportunities and inconsistent support from radiologists. We present a feasibility study from UK of using point of care bowel ultrasound in conjunction with X-ray to aid diagnosis of NEC. We report that that neonatologist performed BUS when used as an additional diagnostic aid has a higher positive predictive value and specificity compared to X-rays alone. Features like absent or poor peristalsis and abnormal bowel perfusion were the most consistent pathological findings in our cohort. Wider implementation of this practice is limited by training opportunities and dedicated support from radiology team.

使用护理点肠超声(BUS)诊断疑似坏死性小肠结肠炎(NEC):可行性研究。
坏死性小肠结肠炎(NEC)是一种潜在的致命的早产合并症,五分之一的患者需要手术干预。尽管其严重,但腹部平片(x线)缺乏客观的影像学标准来指导预后和决策。护理点肠超声(BUS)提供了一个更动态的评估和更多关于肠道健康的信息。然而,由于培训机会和放射科医生不一致的支持,新生儿医生缺乏广泛采用这种做法。我们提出可行性研究,从英国使用点护理肠超声与x线结合,以帮助诊断NEC。我们报道,与单独使用x光相比,新生儿医生将BUS作为额外的诊断辅助具有更高的阳性预测值和特异性。在我们的队列中,蠕动缺失或不良以及肠灌注异常等特征是最一致的病理表现。这种做法的广泛实施受到培训机会和放射科团队的专门支持的限制。
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来源期刊
Journal of the Intensive Care Society
Journal of the Intensive Care Society Nursing-Critical Care Nursing
CiteScore
4.40
自引率
0.00%
发文量
45
期刊介绍: The Journal of the Intensive Care Society (JICS) is an international, peer-reviewed journal that strives to disseminate clinically and scientifically relevant peer-reviewed research, evaluation, experience and opinion to all staff working in the field of intensive care medicine. Our aim is to inform clinicians on the provision of best practice and provide direction for innovative scientific research in what is one of the broadest and most multi-disciplinary healthcare specialties. While original articles and systematic reviews lie at the heart of the Journal, we also value and recognise the need for opinion articles, case reports and correspondence to guide clinically and scientifically important areas in which conclusive evidence is lacking. The style of the Journal is based on its founding mission statement to ‘instruct, inform and entertain by encompassing the best aspects of both tabloid and broadsheet''.
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