Lung Ultrasound in Pediatric and Neonatal Pre-Hospital Care: An Observational Study

The use of point-of-care ultrasound, particularly lung ultrasound (LUS), has grown in pediatric and neonatal intensive care units and also in pre-hospital settings. However, its application in pre-hospital care of pediatric population remains understudied. The objective of the study is to analyze the utility of the LUS in a Paediatric and Neonatal Transport Unit.

This is a prospective observational study conducted in a specialized Paediatric and Neonatal advanced life support Transport Unit in Catalonia, Spain, between March 2021 and September 2023. Patients who underwent bedside LUS during stabilization or transfer for medical reasons were included. Epidemiologic variables, clinical data, transport-related data, and LUS-related data were recorded and analyzed.

During the study period, 2452 patients were transferred. In 89 (3.6%) LUS was performed. Seventy LUS were performed for respiratory distress or cyanosis, 50 of these were in neonatal patients in which transient tachypnea and meconium aspiration were the most frequent diagnoses. LUS was also used during hemodynamic assessment of unstable patients and during cardiac arrest resuscitation. Exactly 87.1% of LUS results were confirmed at the receiving hospital. LUS findings led to a change in patient management in 32 (35.9%) patients.

The rational use of lung ultrasound performed by a pediatric and neonatal transport team can help in diagnostic orientation, management assessment, and improve patient safety.