Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates
IntroductionAssessment of bowel health in ill preterm infants is essential to prevent and diagnose early potentially life-threatening intestinal conditions such as necrotizing enterocolitis. Auscultation of bowel sounds helps assess peristalsis and is an essential component of this assessment.AimWe...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1173332/full |
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| author | Archana Priyadarshi Archana Priyadarshi Mark Tracy Pankhuri Kothari Chiranjibi Sitaula Murray Hinder Faezeh Marzbanrad Stephanie Morakeas Amit Trivedi Nadia Badawi Sheryl Rogerson |
| author_facet | Archana Priyadarshi Archana Priyadarshi Mark Tracy Pankhuri Kothari Chiranjibi Sitaula Murray Hinder Faezeh Marzbanrad Stephanie Morakeas Amit Trivedi Nadia Badawi Sheryl Rogerson |
| author_sort | Archana Priyadarshi |
| collection | DOAJ |
| description | IntroductionAssessment of bowel health in ill preterm infants is essential to prevent and diagnose early potentially life-threatening intestinal conditions such as necrotizing enterocolitis. Auscultation of bowel sounds helps assess peristalsis and is an essential component of this assessment.AimWe aim to compare conventional bowel sound auscultation using acoustic recordings from an electronic stethoscope to real-time bowel motility visualized on point-of-care bowel ultrasound (US) in neonates with no known bowel disease.MethodsThis is a prospective observational cohort study in neonates on full enteral feeds with no known bowel disease. A 3M™ Littmann® Model 3200 electronic stethoscope was used to obtain a continuous 60-s recording of bowel sounds at a set region over the abdomen, with a concurrent recording of US using a 12l high-frequency Linear probe. The bowel sounds heard by the first investigator using the stethoscope were contemporaneously transferred for a computerized assessment of their electronic waveforms. The second investigator, blinded to the auscultation findings, obtained bowel US images using a 12l Linear US probe. All recordings were analyzed for bowel peristalsis (duration in seconds) by each of the two methods.ResultsWe recruited 30 neonates (gestational age range 27–43 weeks) on full enteral feeds with no known bowel disease. The detection of bowel peristalsis (duration in seconds) by both methods (acoustic and US) was reported as a percentage of the total recording time for each participant. Comparing the time segments of bowel sound detection by digital stethoscope recording to that of the visual detection of bowel movements in US revealed a median time of peristalsis with US of 58%, compared to 88.3% with acoustic assessment (p < 0.002). The median regression difference was 26.7% [95% confidence interval (CI) 5%–48%], demonstrating no correlation between the two methods.ConclusionOur study demonstrates disconcordance between the detection of bowel sounds by auscultation and the detection of bowel motility in real time using US in neonates on full enteral feeds and with no known bowel disease. Better innovative methods using artificial intelligence to characterize bowel sounds, integrating acoustic mapping with sonographic detection of bowel peristalsis, will allow us to develop continuous neonatal bowel sound monitoring devices. |
| first_indexed | 2024-03-11T23:35:35Z |
| format | Article |
| id | doaj.art-0464498457854ddfa29bf47b20ef5f62 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-11T23:35:35Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-0464498457854ddfa29bf47b20ef5f622023-09-20T00:16:35ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-09-011110.3389/fped.2023.11733321173332Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonatesArchana Priyadarshi0Archana Priyadarshi1Mark Tracy2Pankhuri Kothari3Chiranjibi Sitaula4Murray Hinder5Faezeh Marzbanrad6Stephanie Morakeas7Amit Trivedi8Nadia Badawi9Sheryl Rogerson10Department of Neonatology, Westmead Hospital Neonatal Intensive Care Unit, Sydney, NSW, AustraliaGrace Neonatal Intensive Care Unit, The Children’s Hospital Westmead, Sydney, NSW, AustraliaDepartment of Neonatology, Westmead Hospital Neonatal Intensive Care Unit, Sydney, NSW, AustraliaDepartment of Neonatology, Westmead Hospital Neonatal Intensive Care Unit, Sydney, NSW, AustraliaDepartment of Electrical & Computer Systems Engineering, Monash University, Clayton, VIC, AustraliaGrace Neonatal Intensive Care Unit, The Children’s Hospital Westmead, Sydney, NSW, AustraliaDepartment of Electrical & Computer Systems Engineering, Monash University, Clayton, VIC, AustraliaDepartment of Neonatology, Westmead Hospital Neonatal Intensive Care Unit, Sydney, NSW, AustraliaGrace Neonatal Intensive Care Unit, The Children’s Hospital Westmead, Sydney, NSW, AustraliaGrace Neonatal Intensive Care Unit, The Children’s Hospital Westmead, Sydney, NSW, AustraliaDepartment of Neonatal Intensive Care Unit, The Royal Women’s Hospital, Melbourne, VIC, AustraliaIntroductionAssessment of bowel health in ill preterm infants is essential to prevent and diagnose early potentially life-threatening intestinal conditions such as necrotizing enterocolitis. Auscultation of bowel sounds helps assess peristalsis and is an essential component of this assessment.AimWe aim to compare conventional bowel sound auscultation using acoustic recordings from an electronic stethoscope to real-time bowel motility visualized on point-of-care bowel ultrasound (US) in neonates with no known bowel disease.MethodsThis is a prospective observational cohort study in neonates on full enteral feeds with no known bowel disease. A 3M™ Littmann® Model 3200 electronic stethoscope was used to obtain a continuous 60-s recording of bowel sounds at a set region over the abdomen, with a concurrent recording of US using a 12l high-frequency Linear probe. The bowel sounds heard by the first investigator using the stethoscope were contemporaneously transferred for a computerized assessment of their electronic waveforms. The second investigator, blinded to the auscultation findings, obtained bowel US images using a 12l Linear US probe. All recordings were analyzed for bowel peristalsis (duration in seconds) by each of the two methods.ResultsWe recruited 30 neonates (gestational age range 27–43 weeks) on full enteral feeds with no known bowel disease. The detection of bowel peristalsis (duration in seconds) by both methods (acoustic and US) was reported as a percentage of the total recording time for each participant. Comparing the time segments of bowel sound detection by digital stethoscope recording to that of the visual detection of bowel movements in US revealed a median time of peristalsis with US of 58%, compared to 88.3% with acoustic assessment (p < 0.002). The median regression difference was 26.7% [95% confidence interval (CI) 5%–48%], demonstrating no correlation between the two methods.ConclusionOur study demonstrates disconcordance between the detection of bowel sounds by auscultation and the detection of bowel motility in real time using US in neonates on full enteral feeds and with no known bowel disease. Better innovative methods using artificial intelligence to characterize bowel sounds, integrating acoustic mapping with sonographic detection of bowel peristalsis, will allow us to develop continuous neonatal bowel sound monitoring devices.https://www.frontiersin.org/articles/10.3389/fped.2023.1173332/fullneonatal bowel soundsbowel peristalsisabdominal ultrasoundauscultationneonates |
| spellingShingle | Archana Priyadarshi Archana Priyadarshi Mark Tracy Pankhuri Kothari Chiranjibi Sitaula Murray Hinder Faezeh Marzbanrad Stephanie Morakeas Amit Trivedi Nadia Badawi Sheryl Rogerson Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates Frontiers in Pediatrics neonatal bowel sounds bowel peristalsis abdominal ultrasound auscultation neonates |
| title | Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates |
| title_full | Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates |
| title_fullStr | Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates |
| title_full_unstemmed | Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates |
| title_short | Comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates |
| title_sort | comparison of simultaneous auscultation and ultrasound for clinical assessment of bowel peristalsis in neonates |
| topic | neonatal bowel sounds bowel peristalsis abdominal ultrasound auscultation neonates |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1173332/full |
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