Diagnostic Utility of Bedside Lung Ultrasonography in Neonates with Respiratory Distress
Asian Journal of Pediatric Research,
Background: Lung Ultrasound (LUS) has recently become an important method for diagnostic examination and monitoring of lung disease. Many lung diseases, such as respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTNB), pneumonia were diagnosed by chest X-ray, but can now easily be diagnosed with LUS. LUS has many advantages over X-ray including accuracy, reliability, low cost, radiation free, simple investigation, do multiple times, results are obtained immediately.
Objective: The aim of this study was to evaluate role of LUS in neonates with respiratory distress (RD) within 4 hours of life and to calculate the sensitivity, specificity, and negative and positive predictive value of LUS for RDS and TTNB, using an external reader blinded to the clinical condition.
Design and Methods: Neonates born at a gestation from 28 weeks to 40 weeks born in the hospital and developing RD on first 4 hours of life were enrolled. The diagnosis based on clinico-radiological features as ascertained by the treating neonatologist was considered gold standard. Just before LUS, the RD was objectively scored using Modified Silverman Andersen score. X-ray and LUS were performed bed side within 4 hours of life. Images were captured and stored and interpreted by the Radiologist who was blinded to the neonate’s clinical condition. LUS were interpreted according to observational index included pleural A lines, B lines, Air bronchogram and Lung consolidation. Based on LUS findings, differentiation between RDS, TTNB, MAS and Pneumonia were made.
Results: 100 neonates were studied. 22 infants had a final diagnosis of RDS and 64 of TTNB. LUS showed a Sn of 100% and Sp of 89.7%, with a PPV of 73.3% and a NPV of 100 % for RDS, and a Sn of 82.8% and Sp of 100% with a PPV of 100% and a NPV of 76.6% for TTNB.
Conclusion: LUS is a reliable method to diagnose RDS and TTNB in newborns with RD with high sn and sp.
- RDS morbidity
How to Cite
Koivisto M, R Marttila, M Kurkinen-Räty, et al. Changing incidence and outcome of infants with respiratory distress syndrome in the 1990s: a population-based survey. Acta Paediatr. 2004;93:177-84.
Ayachi A, V Rigourd, F Kieffer, et al. Hyaline membrane disease in full-term neonates. Arch Pediatr. 2005;12:156-9.
Zechner P, A Seibel, G Aichinger, et al. Lung ultrasound in acute and critical care medicine. Review Anaesthesist. 2012;61: 608-17.
Soboleski D, Cynthia Theriault, Amy Acker, et al. Unnecessary irradiation to non-thoracic structures during pediatric chest radiography. Pediatr Radiol. 2006;36:22-5.
Smith-Bindman R. Is computed tomography safe? N Engl J Med. 2010;363:1-4.
Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38:577-91.
Kumar A, Bhat BV. Epidemiology of respiratory distress of newborns. Ind J Pediatr. 1996;63:93-8.
Liu J, Roberto Copetti, Erich Sorantin, et al. Protocol and guidelines for point-of-care lung ultrasound in diagnosing neonatal pulmonary diseases based on international expert consensus. Vis Exp. 2019 6;145.
Piette E, Raoul Daoust, André Denault et al. Basic concepts in the use of thoracic and lung ultrasound. Review Curr Opin Anaesthesiol. 2013; 26:20-30.
Volpicelli G, Valeria Caramello, Luciano Cardinale, et al. Detection of sonographic B-lines in patients with normal lung or radiographic alveolar consolidation. Med Sci Monit. 2008;14:CR122-8.
Copetti R, Luigi Cattarossi, Franco Macagno et al. Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis. Neonatology. 2008;94:52-9.
Touw H, P R Tuinman, H P M M Gelissen et al. Lung ultrasound: routine practice for the next generation of internists. Review Neth J Med. 2015;73:100-7.
Liu, Jing, et al. Value of lung ultrasound on diagnosing transient tachypnea of newborn. Chinese Journal of Applied Clinical Pediatrics. 2016: 93-96.
Liu J, Fang Liu 2, Ying Liu 3 et al. Lung ultrasonography for the diagnosis of severe neonatal pneumonia. Chest. 2014;146:383-388.
Cattarossi L Lung ultrasound: its role in neonatology and paediatrics. Review Early Hum Dev 2013;89 1:S17-9.
Ahuja C, Akshay Kumar Saxena, Kushaljeet Singh Sodhi, et al. Role of transabdominal ultrasound of lung bases and follow-up in premature neonates with respiratory distress soon after birth. Indian J Radiol Imaging. 2012;22:279-83.
Liu J, Hai-ying Cao, Ying Liu et al. Lung ultrasonography for the diagnosis of neonatal respiratory distress syndrome: a pilot study. Zhonghua Er Ke Za Zhi. 2013;51:205-10.
Rachuri H, Oleti TP, Murki S, et al. Diagnostic performance of point of care ultrasonography in identifying the etiology of respiratory distress in neonates. Ind J Pediatr. 2017 1;84:267-70.
Ibrahim M, A Omran, N B AbdAllah, et al. Lung ultrasound in early diagnosis of neonatal transient tachypnea and its differentiation from other causes of neonatal respiratory distress. J Neonatal Perinatal Med. 2018;11:281-287.
Gupta V, Panigrahy N, Venkatlakshmi A. et al. Diagnostic ability of bedside lung Ultrasound in neonates with respiratory distress. J Pediatr Neonatal Care. 2018; 8:308-12.
Liu J, Fang Liu, Ying Liu, et al. Lung ultrasonography for the diagnosis of severe neonatal pneumonia. Chest. 2014;146:383-388.
Piastra M, Nadya Yousef, Roselyne Brat et al. Lung ultrasound findings in meconium aspiration syndrome. Early Hum Dev. 2014;90 2:S41-3.
Pang H, Bo Zhang, Jing Shi, et al. Diagnostic value of lung ultrasound in evaluating the severity of neonatal respiratory distress syndrome. Eur J Radiol. 2019;116:186-191.
Abstract View: 69 times
PDF Download: 30 times