CRANIAL ULTRASOUND IN CRITICALLY ILL NEONATES

*Sedra Assaf, MD, Oday Jouni, PhD and Fawaz Baddour, PhD

ABSTRACT

Introduction: Cranial ultrasound has become an essential component of neonatal care, as it provids immediate and accurate diagnosis of most of brain injuries that occur in neonate. This study aims to detect the brain injuries in critically ill neonates using ultrasound, and evaluate the clinical correlation with various findings on cranial ultrasonography. Methods: This was a descriptive observational study conducted in the NICU of Tishreen University Hospital in Latakia. It included 124 critically ill neonates admitted to NICU and underwent cranial ultrasonography (CUS) as per inclusion criteria. Different morphological findings were recorded, clinical correlation with CUS findings was made, and follow-up was done until discharge or death. Results: Out of the 124 neonates, 46% had abnormal CUS findings, the most common of which were cerebral edema (14.5%) and intraventricular hemorrhage (14.5%) followed by periventricular echogenicity (6.5%). Abnormal CUS findings were significantly associated with gestational age less than 32 weeks (p=0.032) and birth weight less than 1500 grams (p=0.03). There was also a significant association between abnormal CUS findings and respiratory distress syndrome (p=0.01), persistent pulmonary hypertension (p=0.02), and pneumothorax (p=0.0002). Furthermore, 82.3% of neonates had good outcomes at the time of NICU discharge, and 17,7% died. A significant association between abnormal CUS findings and outcome was found, since most of the neonates who died had abnormal CUS findings. Conclusion: The present study has confirmed the importance of cranial ultrasound as a valuable tool in the NICU, since it provides important possibilities for early diagnosis of brain injuries in critically ill neonates, allowing for early treatment and better clinical outcomes.

Keywords: Cranial Ultrasound, Critically ill neonates, Neonatal Intensive Care Unite.