Elsayed Yasser, Sheldon Josh, Gigolyk Shere
Division of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada.
Am J Perinatol. 2024 May;41(S 01):e1539-e1545. doi: 10.1055/s-0043-1768042. Epub 2023 Apr 18.
We aimed to evaluate the impact of the registered respiratory therapist (RRT) performed point-of-care lung ultrasound (POC-LUS) on patient management in the neonatal intensive care unit (NICU).
This is a retrospective cohort study of neonates who had RRT performed POC-LUS in two level III NICUs in Winnipeg, Manitoba, Canada. The analysis aims mainly to describe the implementation process of the POC-LUS program. The primary outcome was the prediction of the change in clinical management.
A total of 136 neonates underwent 171 POC-LUS studies during the study period. POC-LUS resulted in a change in clinical management following 113 POC-LUS studies (66%), while it supported continuing the same management in 58 studies (34%). The lung ultrasound severity score (LUSsc) was significantly higher in the group with worsening hypoxemic respiratory failure and on respiratory support than infants on respiratory support and stable or not on respiratory support, < 0.0001. LUSsc was significantly higher in infants on either noninvasive or invasive than those not on respiratory support, -value <0.0001.
RRT performed POC-LUS service utilization in Manitoba improved and guided the clinical management of a significant proportion of patients who received the service.
我们旨在评估注册呼吸治疗师（RRT）进行的床旁肺部超声检查（POC-LUS）对新生儿重症监护病房（NICU）患者管理的影响。
这是一项对在加拿大曼尼托巴省温尼伯市的两家三级NICU中接受RRT进行POC-LUS检查的新生儿的回顾性队列研究。该分析主要旨在描述POC-LUS计划的实施过程。主要结局是对临床管理变化的预测。
在研究期间，共有136名新生儿接受了171次POC-LUS检查。在113次POC-LUS检查（66%）后，POC-LUS导致了临床管理的改变，而在58次检查（34%）中支持继续相同的管理。与接受呼吸支持且病情稳定或未接受呼吸支持的婴儿相比，低氧性呼吸衰竭恶化且接受呼吸支持的组的肺部超声严重程度评分（LUSsc）显著更高，P<0.0001。与未接受呼吸支持的婴儿相比，接受无创或有创呼吸支持的婴儿的LUSsc显著更高，P值<0.0001。
在曼尼托巴省，RRT进行的POC-LUS服务利用率提高，并指导了很大比例接受该服务患者的临床管理。
