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Am J Perinatol 2024; 41(S 01): e630-e640
DOI: 10.1055/a-1925-1797
Original Article

Bedside Ultrasound for Early Diagnosis of Necrotizing Enterocolitis: A Pilot Study

Authors

  • Ignacio Oulego-Erroz 

    1   Pediatric Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain

  • Javier Rodríguez-Fanjul 

    2   Pediatric Intensive Care Unit, Hospital Germans Trias i Pujol, Badalona, Spain

  • Sandra Terroba-Seara

    1   Pediatric Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain

  • Clara Sorribes-Orti

    2   Pediatric Intensive Care Unit, Hospital Germans Trias i Pujol, Badalona, Spain

  • David Fernandez-Fernández

    3   Department of Pediatrics, Complejo Asistencial Universitario de León, León, Spain

  • Silvia Fuentes-Martínez

    3   Department of Pediatrics, Complejo Asistencial Universitario de León, León, Spain

  • Álvaro Pou-Blázquez

    3   Department of Pediatrics, Complejo Asistencial Universitario de León, León, Spain

Funding None.
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Abstract

Objective This study aimed to assess whether bedside ultrasound (BUS) as the first imaging modality allows an earlier diagnosis of necrotizing enterocolitis (NEC) compared with abdominal radiography.

Study Design A before–after controlled study in preterm infants with suspected NEC. The intervention group (October 2019–October 2021) received BUS as the first imaging modality and was managed accordingly to BUS findings. The control group (October 2015–September 2019) received radiography as the first imaging modality. The main outcome was NEC confirmation at the time of initial imaging. Secondary outcomes included time to diagnosis, laboratory data, and treatment requirements.

Results Thirty-five episodes of suspected NEC with 14 (40%) confirmed NEC cases and 49 episodes of suspected NEC with 22 (44.9%) confirmed NEC cases were included in the intervention and control groups, respectively. In the intervention group, 11 of 14 (78.6%) NEC cases were confirmed at initial evaluation compared with 5 of 22 (22.7%) in the control group (p = 0.001). Infants in the intervention group developed thrombocytopenia and coagulopathy less frequently, were exposed to less radiation, and required less days of parenteral nutrition compared with the control group (p < 0.05).

Conclusion The use of BUS as the first imaging modality allowed an earlier diagnosis and timely treatment of NEC compared with abdominal radiography.

Key Points

  • This is the first study that has assessed the role of BUS as the first imaging modality in NEC.

  • BUS improves early diagnosis of NEC compared with abdominal radiography.

  • BUS shortens time to NEC confirmation and treatment initiation which may reduce clinical severity of the NEC episode.

Keywords

bedside ultrasound - preterm - necrotizing enterocolitis - biomarker - early diagnosis

Note

The authors declare that the current manuscript contains original material, has not been previously published nor it is has been submitted, or is being considered for publication elsewhere.


Ethics and Consent Statement

The protocol was reviewed and approved by the institutional review boards (IRBs) of both participating centers (CEIC provincial de León; codes PI-20–329 and CIEC Hospital German Trias I Pujol Badalona; code: PI 20–173). Parents or legal guardians of the study participants gave their informed consent for collection and use of clinical and BUS data during the intervention period. As a change in practice, study consent was waived by the IRB for the preintervention period.


Authors' Contributions

All the authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by Ignacio Oulego-Erroz, Javier Rodríguez-Fanjul, Sandra Terroba Seara, Clara Sorribes Ortí, David Fernandez-Fernández, Silvia Fuentes-Martínez, and Álvaro Pou-Blázquez. The first draft of the manuscript was written by Ignacio Oulego-Erroz and all the authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.


Availability of Data and Material

Raw database is available from authors upon request.


Supplementary Material



Publication History

Received: 05 June 2022

Accepted: 01 August 2022

Accepted Manuscript online:
16 August 2022

Article published online:
19 October 2022

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