David T. Saul MD, Presenter: Nothing to Disclose

Samuel Ajayi MD, Abstract Co-Author: Nothing to Disclose

David Schutzman MD, Abstract Co-Author: Nothing to Disclose

Mindy Meislich Horrow MD, Abstract Co-Author: Spouse, Director, Merck & Co, Inc

1. Neonates, especially premature, are especially sensitive to ionizing radiation 2. Small size, inability to breath-hold for chest radiographs (CXR), and lack of skeletal ossification make neonates ideal for thoracic ultrasound (US) with high-frequency probes 3. High-resolution anatomical detail of the neonatal chest is easily displayed in real time 4. In addition to established uses (e.g., pleural effusion), US has utility for evaluation during and after placement of peripherally inserted central venous catheters (PICC), umbilical arterial and venous catheters (UAC), nasogastric tubes (NGT), and endotracheal tubes (ETT)  

1. Background on NICU CXR: Speed/reliability, average dose, # studies performed, potential risks 2. Anatomic and physiologic justification for NICU thoracic US: small size, limited depth allows high frequency (≥12 mHz) scanning.  Thymic tissue and cartilaginous skeleton provide excellent acoustic windows.  Real time scanning reduces issues with rotation and breathing motion. 3. How we do it: review of equipment, scanning technique, and positioning 4. US review of neonatal thoracic anatomy: mediastinum, great vessels, lungs and heart 5. Diagnostic uses: a. Lung/pleura: pulmonary edema, pneumothorax, pleural effusion b. Line placement and complications: PICC, UAC, UVC c. Tube placement: ET, NGT  

http://abstract.rsna.org/uploads/2014/14006887/14006887_8yeg.pdf

Saul, D, Ajayi, S, Schutzman, D, Horrow, M, New Uses for Thoracic Ultrasound in the Neonatal Intensive Care Unit: Old Dog, New Tricks.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006887.html