Publish in this journal
Journal Information
Vol. 47. Issue 1.
Pages 16-22 (January 2023)
Share
Share
Download PDF
More article options
ePub
Visits
...
Vol. 47. Issue 1.
Pages 16-22 (January 2023)
Original article
Lung ultrasound protocol decreases radiation in newborn population without side effects: A quality improvement project
La implementación de un protocolo de ecografía pulmonar disminuye la radiación sin efectos secundarios: proyecto de mejora cualitativa
Visits
...
J. Rodriguez-Fanjula,b,
Corresponding author
, N. Benetc, C. Rodrigo Gonzalo de Lliriad, R. Portac, G. Guinovartc, S. Bobillo-Péreze
a Neonatology Unit, Paediatric Department, Institut d’Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
b Working Group on Ultrasound of the Spanish Society of Neonatology (SENeo), Valencia, Spain
c Neonatology Unit, Paediatric Department, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
d Paediatric Department, Institut d’Investigació Germans Trias i Pujol, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
e Disorders of Immunity and Respiration of the Paediatric Critical Patient Research Group, Institut Recerca Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (4)
Show moreShow less
Abstract
Objective

To reduce radiation exposure in newborns admitted due respiratory distress based on the implementation of lung ultrasound (LUS).

Design

Quality improvement (QI), prospective, before-after, pilot study.

Setting

Third level neonatal intensive care unit (NICU) level with 25-bed and 1800 deliveries/year.

Patients

Inclusion criteria were neonates admitted with respiratory distress.

Interventions

After a theoretical and practical LUS training a new protocol was approved and introduced to the unit were LUS was the first-line image. To study the effect of the intervention we compare two 6-month periods: group 1, with the previous chest X-ray (CXR)-protocol (CXR as the first diagnostic technique) vs. group 2, once LUS-protocol had been implemented.

Main variables of interest

The main QI measures were the total exposure to radiation. Secondary QI were to evaluate if the LUS protocol modified the clinical evolution as well as the frequency of complications.

Results

122 patients were included. The number of CXR was inferior in group 2 (group 1: 2 CXR (IQR 1–3) vs. Group 2: 0 (IQR 0–1), p<0.001), as well as had lower median radiation per baby which received at least one CXR: 56 iGy (IQR 32–90) vs. 30 iGy (IQR 30–32), p<0.001. Respiratory support was similar in both groups, with lower duration of non-invasive mechanical ventilation and oxygen duration the second group (p<0.05). No differences regarding respiratory development complications, length of stay and mortality were found.

Conclusions

The introduction of LUS protocol in unit decreases the exposure radiation in infants without side effects.

Keywords:
Lung ultrasound
Radiation
Newborn
Resumen
Objetivo

Reducir la exposición a la radiación en neonatos ingresados por distrés respiratorio mediante implementación de la ecografía pulmonar (EP).

Diseño

Estudio piloto, prospectivo, anterior-posterior, mejoría de la calidad.

Ámbito Unidad de cuidados intensivos neonatal (UCIN) de tercer nivel con 25 camas y 1800 partos/anuales.

Pacientes

Criterio de inclusión neonatos con distrés respiratorio.

Intervenciones

Después de una formación teórico-práctica en EP un nuevo protocolo fue implementado y aprobado siendo la EP la primera técnica de imagen. Para estudiar el efecto de la intervención comparamos dos períodos de 6 meses: grupo 1, con el protocolo de radiografía de tórax (RTX) (RTX primera técnica diagnóstica) vs. grupo 2, una vez implementado el protocolo de EP.

Variables de interés

La principal variable de interés fue la exposición total a la radiación. Las secundarias fueron la evolución clínica y la frecuencia de complicaciones.

Resultados

Se incluyeron 122 pacientes. El número de RTX fue inferior en el grupo 2 (grupo 1: 2 RTX [RIQ 1-3] vs. grupo 2: 0 [RIQ 0-1], p<0,001), con una menor dosis de radiación media por cada paciente que recibió al menos una RTX: 56 iGy (RIQ 32-90) vs. 30 iGy (RIQ 30-32), p<0,001. El soporte respiratorio fue similar en ambos grupos, con menor duración de la ventilación no invasiva y oxigenoterapia en el segundo grupo (p< 0,05). No hubo diferencias en el desarrollo de complicaciones respiratorias, días de ingreso o mortalidad.

Conclusiones

La introducción de un protocolo de EP en una unidad disminuye la exposición a la radiación sin efectos secundarios.

Palabras clave:
Ecografía pulmonar
Radiación: Neonato

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?