An Evaluation of Vital Signs in Intubated Neonates Undergoing Lung Point-of-Care Ultrasound in the Neonatal Intensive...

Point-of-care ultrasound (POCUS) within the neonatal intensive care unit (NICU) is an emerging field that is being utilized with increasing frequency. Lung POCUS is employed with multiple validated uses, which include determining the need for surfactant in respiratory distress syndrome and the timing of appropriate extubation in neonates receiving mechanical ventilation. Previous data showed cardiorespiratory stability with other indications of POCUS, though it remains unclear whether this is observed in lung POCUS exams in intubated neonates. Our goal is to evaluate the cardiorespiratory stability of intubated neonates undergoing lung POCUS exams.

This was a prospective, IRB-approved, multisite study assessing the cardiorespiratory stability of lung POCUS exams. Vital signs data, including heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO2), were collected before and after lung POCUS scans and were assessed for equivalence. Limits of equivalence were set beforehand.

Vital signs equivalence for HR, RR, and SpO2 was demonstrated for lung POCUS exams performed prior to and following extubation. For the pre-extubation period, HR increased by 3.93 beats/min, RR increased by 2.31 breaths/min, and SpO2 increased by 0.26%. For the postextubation period, HR increased by 3.05 beats/min, RR decreased by -0.72 breaths/min, and SpO2 decreased by -0.42%.

Lung POCUS exams do not appear to affect the cardiorespiratory stability of intubated neonates, suggesting that lung POCUS can be performed without affecting cardiorespiratory stability within the NICU setting on critically ill neonates for diagnostic purposes.