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当前加拿大新生儿重症监护病房实施肺部超声的认知和障碍:一项全国性调查。

Current perception and barriers to implementing lung ultrasound in Canadian neonatal intensive care units: a national survey.

机构信息

Department of Pediatrics, Sinai Health System, University of Toronto, Toronto, Canada.

Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Eur J Pediatr. 2024 Aug;183(8):3499-3508. doi: 10.1007/s00431-024-05591-7. Epub 2024 May 24.

Abstract

Despite the growing body of literature supporting the use of point-of-care lung ultrasound (POC-LU) in neonates, its adoption in Canadian neonatal intensive care units (NICUs) remains limited. This study aimed to identify healthcare providers' perceptions and barriers to implementing POC-LU in Canadian NICUs. We conducted an electronic survey targeting neonatologists, neonatal fellows, neonatal nurse practitioners, and registered respiratory therapists in 20 Canadian NICUs. The survey comprised a 28-item questionnaire divided into four sections: (1) participants' demographics and availability of POC-LU equipment, (2) experience and interest in POC-LU learning, (3) perception of POC-LU as a diagnostic tool, and (4) barriers to POC-LU implementation in NICUs. A total of 194 participants completed the survey, with neonatologists comprising the majority (45%). Nearly half of the participants (48%) reported prior experience with POC-LU. The most prevalent indications for POC-LU use were diagnosis of pleural effusion (90%), pneumothorax (87%), and respiratory distress syndrome (76%). Participants identified the primary barrier to POC-LU adoption as the lack of trained providers available for both training and clinical integration. Notably, most respondents (87%) expressed keen interest in learning neonatal POC-LU. A subgroup analysis based on the responses collected from NICU-directors of 12 institutions yielded results consistent with those of the overall participant pool.     Conclusion: This survey underscores the perceived importance of POC-LU among NICU healthcare providers. A Canadian consensus is required to facilitate the development of widespread training programs as well as standardized clinical practice guideline for its implementation. What is Known: • In recent years, point-of-care lung ultrasound (POC-LU) has emerged as an important tool in neonatology, revolutionizing the assessment and management of critically ill infants. However, its adoption in Canadian Neonatal Intensive Care Units remains limited. What is New: • Most Canadian healthcare providers showed high level of interest in learning POC-LU techniques. Additionally, POC-LU was perceived as a useful tool for diagnosis and guiding intervention in various neonatal respiratory diseases. Nonetheless, the lack of expertise emerged as the primary barrier to its adoption and practice across different groups of participants regardless of their clinical experience level.

摘要

尽管越来越多的文献支持在新生儿中使用即时床旁超声(POC-LU),但其在加拿大新生儿重症监护病房(NICU)中的应用仍然有限。本研究旨在确定医疗保健提供者在加拿大 NICU 中实施 POC-LU 的看法和障碍。我们对 20 家加拿大 NICU 的新生儿科医生、新生儿研究员、新生儿护士从业者和注册呼吸治疗师进行了电子调查。该调查由 28 个项目的问卷组成,分为四个部分:(1)参与者的人口统计学和 POC-LU 设备的可用性,(2)对 POC-LU 学习的经验和兴趣,(3)对 POC-LU 作为诊断工具的看法,以及(4)NICU 中实施 POC-LU 的障碍。共有 194 名参与者完成了调查,其中新生儿科医生占多数(45%)。近一半的参与者(48%)报告有 POC-LU 的先前经验。最常见的 POC-LU 应用指征是诊断胸腔积液(90%)、气胸(87%)和呼吸窘迫综合征(76%)。参与者将 POC-LU 采用的主要障碍确定为缺乏可用于培训和临床整合的训练有素的提供者。值得注意的是,大多数受访者(87%)对学习新生儿 POC-LU 表现出浓厚的兴趣。对来自 12 家机构的 NICU 主任的回复进行的子组分析得出的结果与整个参与者群体的结果一致。结论:这项调查强调了 NICU 医疗保健提供者对 POC-LU 的认知重要性。需要达成加拿大共识,以促进广泛的培训计划的发展,并制定其实施的标准化临床实践指南。已知内容:·近年来,即时床旁超声(POC-LU)在新生儿学中已成为一种重要工具,彻底改变了对危重新生儿的评估和管理。然而,其在加拿大新生儿重症监护病房的应用仍然有限。新内容:·大多数加拿大医疗保健提供者对学习 POC-LU 技术表现出浓厚的兴趣。此外,POC-LU 被认为是诊断和指导各种新生儿呼吸系统疾病干预的有用工具。然而,缺乏专业知识是无论其临床经验水平如何,各组成员采用和实践 POC-LU 的主要障碍。

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