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Observational Study
. 2024 Jun;43(6):1089-1097.
doi: 10.1002/jum.16437. Epub 2024 Feb 25.

Cranial Point-of-Care Ultrasound for Neonatal Providers: A Feasibility Study

Sarah E Kolnik  1 , Annika Sahota  1 , Thomas R Wood  1   2 , Kendell German  1   2 , Mihai Puia-Dumitrescu  1 , Ulrike Mietzsch  1 , Manjiri Dighe  3 , Janessa B Law  1
Affiliations
Observational Study

Cranial Point-of-Care Ultrasound for Neonatal Providers: A Feasibility Study

Sarah E Kolnik et al. J Ultrasound Med. 2024 Jun.

Abstract

Objective: Despite strong evidence for its utility in clinical management and diagnosis of intracranial hemorrhage (ICH), the use of neonatal cranial point-of-care ultrasound (POCUS) has not been standardized in neonatal intensive care units (NICUs) in the United States. The primary aim of this study was to evaluate the feasibility of training NICU providers to perform cranial POCUS by tracking the quality of image acquisition following training.

Methods: Observational single-center cohort study of cranial POCUS images obtained by trained neonatal practitioners (attendings, fellows, and advanced practice providers) using a protocol developed by a radiologist and neonatologist. Exams were performed on infants born ≤1250 g and/or ≤30 weeks gestation within the first 3 days after birth. A survey to assess attitudes regarding cranial POCUS was given before each of three training sessions. Demographic and clinical data collection were portrayed with descriptive statistics. Metrics of image quality were assessed by a radiologist and sonographer independently. Analysis of trends in quality of POCUS images over time was performed using a multinomial Cochran-Armitage test.

Results: Eighty-two cranial POCUS scans were performed over a 2-year period. Infant median age at exam was 14 hours (IQR 7-22 hours). Metrics of image quality depicted quarterly demonstrated a significant improvement in depth (P = .01), gain (P = .048), and quality of anatomy images captured (P < .001) over time. Providers perceived increased utility and safety of cranial POCUS over time.

Conclusion: Cranial POCUS image acquisition improved significantly following care team training, which may enable providers to diagnose ICH at the bedside.

Keywords: cranial POCUS; intracranial hemorrhage; neonates.

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