Point of care lung ultrasound service in neonatal intensive care: Five years of experience in Manitoba, Canada

OBJECTIVE

To evaluate the utility of a point of care lung ultrasound (POC-LUS) on patient management in the Neonatal Intensive Care Unit (NICU).

STUDY DESIGN

A retrospective cohort study of neonates who had POC-LUS from 2016 to 2020 in two-level III NICUs in Winnipeg, Manitoba, Canada. The primary outcome was the change in clinical management. The analysis aims mainly to describe the implementation process of the POC-LUS program.

RESULTS

A total of 956 neonates underwent 4076 POC-LUS studies during the study period. The number of POC-LUS studies increased significantly every year, from 316 (in 2016) to 1257 (in 2020) (p < 0.001). POC-LUS resulted in a change in clinical management following 2528 POC-LUS studies (62%), while it supported continuing the same management in 1548 studies (38%).

CONCLUSION

POC-LUS in Manitoba increased since its inception and led to an alteration in the clinical management in a significant proportion of patients who received the service.

Unit activity in human thalamic reticularis nucleus. I. Spontaneous activity

Microelectrode recording was carried out in the thalamic reticularis nucleus (Rt) during 51 stereotaxic operations performed in locally anesthetized dyskinetic patients. The spontaneous activity (SA) of 426 units was studied by means of computer processing techniques. Three types of unit (A, B, C) were shown to exist in Rt: with irregular low-frequency (0-10/sec) discharges (A type, 51%); bursting in short trains (10-30 msec) with unstable rhythmic pattern (2-5/sec; B type, 42%); presenting long duration (0.1-2 sec) high frequency bursts and relatively constant interburst silences (80-150 msec; C type, 7%). During short-term anesthesia A unit discharges disappeared; on the contrary the rhythmic bursts of B neurons were synchronized and presented a more stable frequency. The 3 types of cell were present in the whole Rt. However, a number of discharge characteristics (frequency, variation of rhythm) of A and B units changed significantly with the position of the cells in the Rt. No relationship was found between the frequencies of the rhythmic bursts and the parkinsonian tremor. With the use of a multiparametric statistical procedure, a relation was, however, found between the intensity of the peripheral tremor and the stability of the average frequency of the B type rhythmic bursts. The possible origins of rhythmic bursts of B and C neurons are discussed.