Neonatal Ultrasound Program Promises Improved Outcomes

The Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU) at CHOP recently initiated the Point-of-Care Neonatal Ultrasound Program under the leadership of attending neonatologists Maria Fraga, MD, and Jason Stoller, MD. It has 2 main goals:

1. To improve bedside clinical and physiologic assessment of infants with hemodynamic instability.
2. To improve patient safety and success rates during the following procedures: PICC line placement, arterial and peripheral venous access, suprapubic tap, paracentesis, pericardiocentesis, and thoracocentesis.

Visualization of femoral vessels for PICC line insertion guided by ultrasound The emerging field of point-of-care ultrasound can offer a clearer understanding of the pathophysiology underlying hemodynamic instability and help refine the therapeutic care plan. Functional echocardiography is expected to help provide targeted treatments based on actual and not assumed functional status. Therefore, the availability of bedside ultrasound in the N/IICU may assist with management and improve short-term outcomes and patient safety.

There is a growing acceptance that neonatologist-performed ultrasound is a useful tool in the NICU, with increasing evidence of improved patient outcomes. The development of our ultrasound program will allow collection of real-time, longitudinal point-of-care information, assisting the clinician in understanding cardiac function and hemodynamic changes.

Hospitals focusing on patient safety have also embraced national and international safety guidelines that strongly recommend the use of ultrasound for central venous access. Procedures guided by ultrasound increase success rates and improve quality of care as well as reduce costs by decreasing the need for consultative services such as interventional radiology for central line placement.

Furthermore, our hope is that this program will stimulate innovative research and thus refine and extend the indications of this modality to benefit patients in NICUs everywhere.

Point-of-Care Ultrasound Training Courses for clinicians are held twice a year at CHOP. For more information, contact Maria Fraga at fragam@email.chop.edu.