RAD Our Experience Using the MobileDaRt Evolution for Neonatal Care

Current advances in neonatal care not only include medical equipment designed for small infants, such as advances in incubators used to maintain infant body temperatures at a constant level and ventilators able to gently control respiration in even the lungs of newborns that weigh less than 1000 grams, but also clearly include major contributions from developments in drugs, such as artificial lung surfactants used to dramatically improve treatment of respiratory distress syndrome, which is the most common disorder facing premature infants with respiratory insufficiency. Because premature infants have insufficiently developed lungs and intestinal tracts, neonatal care primarily involves controlling respiration and providing nutrition via a feeding tube. Consequently, conventional X-rays serve an extremely important role at the NICU (Neonatal Intensive Care Unit), for diagnostics and selection of treatment method. However, as we have gained experience and better understanding of pathophysiology, the use of X-ray imaging has decreased due to concerns regarding radiation exposure. Furthermore, as the use of ultrasound examination equipment has become more widespread, conventional X-rays are no longer used as frequently. It now appears that examinations are mainly performed using ultrasound. Ultrasound examination systems have now become an essential tool in NICUs. That is probably because ultrasound enables immediately viewing still and moving images on-the-spot, which provides more bedside information than a single black and white X-ray image. In addition, treatment with artificial lung surfactants has made respiratory care far easier than before, so there is no longer the need to obtain multiple X-ray images of the lungs. What's more, in the field of neonatal care, it is left up to the neonatal physicians to read X-ray images. With radiography now being treated as an examination method of a previous generation, there are fewer doctors able to read chest and abdominal X-ray images properly. That has no doubt contributed to the decline of conventional radiography. Nevertheless, even with better treatment methods and better medical equipment now available, when faced with an emergency, we are acutely reminded how conventional radiography still is extremely important for imaging. In particular, mobile X-ray systems required time for processing. Therefore, during an emergency, the time delay would make us feel impatient waiting for the images. That is why our hospital introduced a Shimadzu MobileDaRt Evolution unit (Fig. 1) equipped with a compact FPD, which enables obtaining images inside incubators, in our pediatrics department, when the NICU moved to a new building in April 2011. This has also been useful for neonatal care, as described in the cases below.