# Availability, utilization, and barriers to bowel ultrasound for necrotizing enterocolitis... — GCMD Library

Dr. Lizzy Lee from Cincinnati Children's discusses a national multidisciplinary survey on the availability and use of bowel ultrasound (BUS) for diagnosing necrotizing enterocolitis (NEC). The study found that while BUS is available in many Level 4 NICUs, routine utilization is inconsistent due to barriers like lack of standardized protocols, limited provider training, and uncertainty in guiding treatment decisions. This article highlights the need for better evidence, standardized guidelines, and improved clinician training to enhance BUS adoption for NEC.

Alain Cuna, Julie D Thai, Kera McNelis, Loren Berman, Katie Huff, Sujir Pritha Nayak, Amy E O'Connell, Catherine J Hunter, Hala Chaaban, Eshanika Manchanda, Amina M Bhatia, Kate Louise M Mangona, Leeann Pavlek, Parvesh Garg, Lauren C Frazer, Mohan Pammi, Catalina Le Cacheux, Bhuvaneshwari Jagadesan, Toby D Yanowitz, Irfan Ahmad, Muralidhar H Premkumar

Objective: To characterize availability, utilization, and barriers to bowel ultrasound (BUS) for necrotizing enterocolitis (NEC).

Methods: A survey of neonatologists, surgeons, and radiologists at Children's Hospitals' Neonatal Consortium (CHNC) sites. Quantitative data were analyzed descriptively; open-ended responses underwent thematic analysis.

Results: In total, 104 respondents from 42/46 institutions participated. BUS was available at 83% of level IV NICU sites, with 64% reporting 24/7 availability. However, only 42% of affiliated level III NICUs had BUS available. BUS was primarily used alongside radiographs in cases of diagnostic uncertainty and variably used to guide surgical decisions. Radiologists frequently used protocols while neonatologists and surgeons reported limited training and few institutional guidelines. Key barriers included lack of standardization, inadequate training, and unclear clinical utility.

Conclusion: BUS is increasingly available in level IV NICUs but less so in level III NICUs. Even when available, clinical integration is inconsistent due to gaps in standardization, training, and supporting evidence.

Type: video · 0 min · posted 2026-07-14
Canonical: https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575

## Chapters
- [0:00](https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575?t=0) Bowel Ultrasound Adoption Barriers in NEC Diagnosis

## Statements
- "Bowel ultrasound is becoming an important tool for diagnosing necrotizing enterocolitis" — Lizzie Lee (clinical) [0:08](https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575?t=8)
- "A national survey included more than 100 neonatologists, surgeons, and radiologists from 42 children's hospitals" — Lizzie Lee (epidemiological) [0:19](https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575?t=19)
- "Bowel ultrasound was available in 83% of level 4 NICUs" — Lizzie Lee (epidemiological) [0:26](https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575?t=26)
- "Clinicians reported using bowel ultrasound inconsistently, most often only when X-rays were inconclusive" — Lizzie Lee (clinical) [0:26](https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575?t=26)
- "The biggest barriers to bowel ultrasound adoption were lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions" — Lizzie Lee (clinical) [0:36](https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575?t=36)
- "Wider adoption of bowel ultrasound for NEC will depend on better evidence, standardized guidelines, and improved clinician training" — Lizzie Lee (opinion) [0:46](https://library.globalcastmd.com/watch/availability-utilization-and-barriers-to-bowel-ultrasound-for-necrotizing-enterocolitis-13575?t=46)

## Transcript
Do you routinely use bowel ultrasound to diagnose necrotizing enterocolitis? I'm Lizzie Lee from Cincinnati Children's, and this is an article you should know about. Bowel ultrasound is becoming an important tool for diagnosing necrotizing enterocolitis, or NEC. But this national survey found that availability doesn't always translate into routine use. They surveyed more than 100 neonatologists, surgeons, and radiologists from 42 children's hospitals. While bowel ultrasound was available in 83% of level 4 NICUs, clinicians reported using it inconsistently, most often only when X-rays. Were inconclusive. The biggest barriers weren't the technology itself, they were the lack of standardized protocols, limited provider training, and uncertainty about how bowel ultrasound should guide treatment decisions. So bowel ultrasound shows real promise for NEC, but wider adoption will depend on better evidence, standardized guidelines, and improved clinician training. Let us know what you think below.

---
Not medical advice · citation policy: https://library.globalcastmd.com/ai