Survey Reveals Ultrasound Practices in Neonatal Medicine

In the rapidly evolving landscape of neonatal-perinatal medicine, advances in diagnostic technologies are reshaping the way healthcare providers approach the fragile and complex population of newborns. Among these technological strides, point of care ultrasound (POCUS) has surged into the spotlight due to its promise of immediate bedside imaging that can transform clinical decision-making in neonatal intensive care units (NICUs). A recently published national survey conducted across academic neonatal-perinatal medicine (NPM) centers in the United States sheds light on how POCUS is being integrated into clinical practice, the infrastructural components driving its adoption, and the persistent barriers that hinder its widespread implementation. This comprehensive evaluation offers both a snapshot of current utilization patterns and a roadmap for future program development, underscoring POCUS as a pivotal tool in neonatal care.

The role of POCUS in neonatal-perinatal medicine cannot be overstated. Unlike traditional imaging modalities that often require patient transport and scheduling delays, POCUS enables immediate, real-time visualization of anatomical structures and physiological states at the bedside. This capability is particularly crucial for neonates, where rapid clinical changes demand swift diagnostic answers without exposing these vulnerable patients to unnecessary movement or radiation. The national survey, spearheaded by researchers Miller, Ruoss, and Chaves among others, sought to quantify how extensively POCUS is being utilized across academic NPM centers and to what extent programs have embedded this technology within their clinical and educational frameworks.

One of the survey’s most striking revelations is the uneven distribution of POCUS adoption. While some academic centers have fully embraced POCUS, not only as a diagnostic adjunct but as a core competency for their NPM fellows and attending physicians, others remain in the nascent stages of program development. This discrepancy often correlates with the presence or absence of dedicated infrastructural elements such as faculty expertise, access to ultrasound machines, and formalized training curricula. Centers with established POCUS programs commonly report enhanced diagnostic accuracy, improved timing of interventions, and a greater sense of clinical confidence among providers.

Delving deeper into the infrastructural factors, the survey highlighted the importance of programmatic support that extends beyond mere equipment acquisition. Successful integration of POCUS depends heavily on having trained faculty who can supervise and mentor trainees, standardized protocols for image acquisition and interpretation, and quality assurance mechanisms that ensure consistent and reliable use. The presence of interdisciplinary collaboration also emerged as a key enabler, with some programs leveraging partnerships with radiology, cardiology, and emergency medicine specialties to buttress their POCUS expertise and resource sharing.

Despite these encouraging developments, significant barriers continue to impede universal adoption of POCUS in neonatal settings. The survey identified several common challenges, foremost among them being limited faculty proficiency and time constraints that obstruct adequate training. Additionally, nebulous credentialing pathways and a lack of consensus on scope-of-practice contribute to uncertainty and variable uptake. The financial burden related to equipment procurement and maintenance further complicates the picture, especially for programs operating under tight budgetary constraints. Collectively, these hurdles underscore the need for national guidelines and institutional commitment that prioritize POCUS competency.

Another compelling aspect uncovered by the survey is the variation in how POCUS is utilized diagnostically within neonatal-perinatal medicine. Common applications include cardiac function assessment, lung ultrasonography for conditions such as pneumothorax or pulmonary edema, and abdominal imaging to evaluate for necrotizing enterocolitis or intestinal obstruction. The immediacy with which POCUS can aid in these diagnoses fundamentally enhances clinical workflow and patient outcomes, emphasizing its role as an extension of the physical exam rather than a standalone imaging test. This conceptual shift requires ongoing education to ensure clinicians appropriately integrate POCUS findings within broader clinical context.

Training and education emerge as foundational pillars for sustainable POCUS program development. Survey respondents underscored the importance of formalized curricula tailored to neonatal-pathophysiology and sonographic interpretation specific to this population. Simulation-based learning, hands-on workshops, and continuous competency assessments feature prominently in high-functioning programs. Furthermore, embedding POCUS training early in fellowship education promotes a culture of proficiency that permeates through to attending staff, encouraging longitudinal skill retention. This educational infrastructure lays the groundwork for POCUS to become an indispensable diagnostic tool embraced across the field.

The impact of POCUS on neonatal-perinatal medicine extends beyond bedside diagnosis to influence research and quality improvement initiatives. Incorporating POCUS into clinical protocols enables real-time data collection, facilitating robust outcomes research and iterative refinement of care pathways. The survey indicates that programs invested in POCUS development are more likely to engage in scholarly activity centered on ultrasound applications, further driving innovation. Moreover, quality assurance programs that routinely review POCUS images and interpretations enhance diagnostic accuracy, reduce variability, and elevate overall patient safety.

Interdisciplinary collaboration emerges as another critical theme shaping the trajectory of POCUS adoption. Neonatal care is inherently complex, often requiring input from various subspecialties. The survey highlights instances where collaborative POCUS training and shared usage protocols have enhanced both resource utilization and educational exchange. Radiology departments, in particular, can offer essential support in formal image review and machine maintenance, while cardiology specialists contribute to advanced echocardiographic skills development. These synergies foster a comprehensive environment conducive to maximizing POCUS benefits for neonatal patients.

As technological advancements continue to make ultrasound devices more portable, affordable, and user-friendly, the potential for expanding POCUS use in neonatal-perinatal medicine grows exponentially. Handheld devices capable of high-resolution imaging, integrated artificial intelligence algorithms for image interpretation, and tele-ultrasound capabilities promise to democratize access to this modality even in resource-limited settings. The findings of this national survey paint a picture of a field on the cusp of widespread POCUS integration, provided that educational, infrastructural, and policy-related barriers are addressed in a systematic and strategic manner.

Considering the clinical implications, the immediate diagnostic accuracy and timeliness offered by POCUS have the potential to reduce invasive procedures, limit radiation exposure, and improve hemodynamic and respiratory management in neonates. This aligns with the overarching goal of neonatal-perinatal medicine to provide the safest and most effective care tailored to this uniquely vulnerable population. However, as the survey indicates, cautious optimism is warranted; the benefits of POCUS must be balanced against the necessity for rigorous training, standardized protocols, and robust quality controls to prevent misdiagnosis or overreliance on ultrasound findings in isolation.

Looking ahead, the adoption trajectory of POCUS in neonatal-perinatal medicine is likely to be influenced by emerging evidence delineating its impact on clinical outcomes, cost-effectiveness, and educational efficacy. The survey serves as a clarion call to professional societies, hospital administrations, and funding agencies to catalyze the development of consensus guidelines, credentialing standards, and incentivization mechanisms. By doing so, the neonatal-perinatal community can harness the full potential of diagnostic POCUS to transform care delivery and improve neonatal outcomes on a national scale.

In summary, this comprehensive national survey provides invaluable insight into the current landscape of diagnostic point of care ultrasound usage within academic neonatal-perinatal medicine centers in the United States. It reveals a field marked by innovation and enthusiasm juxtaposed against infrastructural and educational challenges. As POCUS technology becomes increasingly indispensable, aligning programmatic resources and overcoming implementation barriers will be essential to embedding this modality firmly into neonatal clinical practice. The survey’s findings underscore the urgent need for concerted efforts to standardize training, streamline credentialing, and foster interdisciplinary collaboration, thereby unlocking the transformative promise of POCUS for the youngest and most fragile patients.

The momentum behind POCUS in neonatal-perinatal medicine reflects a broader trend in healthcare towards immediate, bedside diagnostic tools that empower clinicians and improve patient outcomes. This paradigm shift embodies the intersection of technology, education, and patient-centered care, heralding a new era in neonatology. As academic centers continue to spearhead program development and generate evidence supporting POCUS efficacy, it is imperative that this momentum extends beyond institutional silos into widespread adoption. The journey towards routine utilization of diagnostic ultrasound at the point of care represents not only a technological advance but a cultural evolution in neonatal-perinatal medicine.

Ultimately, the national survey led by Miller, Ruoss, Chaves, and colleagues serves as a foundational benchmark, charting the current state and future directions of POCUS integration in neonatal-perinatal medicine. Their work highlights that while the technology holds immense promise, its successful deployment hinges on a robust framework that encompasses faculty development, curricular innovation, quality assurance, and collaborative partnerships. Addressing these multifaceted challenges will pave the way for diagnostic POCUS to become a standard of care that enhances the quality, safety, and outcomes for neonates across the United States.

Subject of Research: Diagnostic point of care ultrasound (POCUS) utilization, infrastructural components, and barriers in neonatal-perinatal medicine programs in the United States.

Article Title: National survey of diagnostic point of care ultrasound practices and program development in academic neonatal-perinatal medicine centers.

Article References:
Miller, K., Ruoss, J.L., Chaves, D.V. et al. National survey of diagnostic point of care ultrasound practices and program development in academic neonatal-perinatal medicine centers. J Perinatol (2025). https://doi.org/10.1038/s41372-025-02307-z

Image Credits: AI Generated

DOI: https://doi.org/10.1038/s41372-025-02307-z

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