Availability, utilization, and barriers to bowel ultrasound for necrotizing enterocolitis (NEC): A national multidisciplinary survey
Topic overview
National survey of 100+ clinicians across 42 children's hospitals reveals that while bowel ultrasound is available in 83% of level 4 NICUs, inconsistent use persists due to lack of standardized protocols, limited training, and unclear treatment algorithms. Wider adoption for NEC diagnosis requires evidence-based guidelines and structured training programs.
Key takeaways
- Bowel ultrasound is available at 83% of level IV NICUs but only 42% of level III NICUs, creating disparities in diagnostic access.
- BUS is primarily used as an adjunct to radiographs in uncertain cases rather than as a standardized first-line diagnostic tool for NEC.
- Radiologists use protocols for BUS while neonatologists and surgeons report limited training and few institutional guidelines.
- Key implementation barriers include lack of standardization, inadequate provider training, and unclear evidence for clinical utility.
- Even when BUS is available 24/7, clinical integration remains inconsistent across institutions and specialties.
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