Neonatal SONography Assisted Resuscitation (NeoSONAR): Scoping review of the current literature and future directions

Ultrasound is increasingly utilized during cardiac arrest in adult populations. The European Society of Pediatric and Neonatal Intensive Care and the American Academy of Pediatrics have published guidelines on the use of point-of-care ultrasound (POCUS) in neonates and children. However, there were no specific recommendations for its use during the Neonatal Resuscitation Program (NRP) algorithm. In this narrative review, we map the existing evidence to evaluate its role, potential benefits, and limitations of POCUS integration during neonatal resuscitation. The limited available studies, mostly case reports, suggest that POCUS can aid in the early identification of correctable or modifiable causes, evaluation of cardiac function, detection of heart rate or pulseless electrical activity, and guidance of resuscitative efforts. Significant gaps remain in knowledge, research studying its feasibility and benefits, and a lack of specific training and standardized protocols for integrating POCUS into the NRP algorithm, emphasizing the need for further research.