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
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This is the first study that has assessed the role of BUS as the first imaging modality
in NEC.
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BUS improves early diagnosis of NEC compared with abdominal radiography.
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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
