Lung ultrasound (LUS) is now widely used in the diagnosis and monitor of neonatal lung diseases.Nevertheless, in the published literatures,the LUS images may display a significant variation in technical execution,while scanning parameters may influence diagnostic accuracy.The inter-and intra-observer reliabilities of ultrasound exam have been extensively studied in general and in LUS.As expected,the reliability declines in the hands of novices when they perform the point-of-care ultrasound (POC US).Consequently,having appropriate guidelines regarding to technical aspects of neonatal LUS exam is very important especially because diagnosis is mainly based on interpretation of artifacts produced by the pleural line and the lungs.The present work aimed to create an instrument operation specification and parameter setting guidelines for neonatal LUS.Technical aspects and scanning parameter settings that allow for standardization in obtaining LUS images include (1)select a high-end equipment with high-frequency linear array transducer (12-14 MHz).(2)Choose preset suitable for lung examination or small organs.(3)Keep the probe perpendicular to the ribs or parallel to the intercostal space.(4)Set the scanning depth at 4-5 cm.(5)Set 1-2 focal zones and adjust them close to the pleural line.(6)Use fundamental ARTICLE HISTORY
Background: Potential functions of cytoglobin (CYGB) in neonatal hypoxia-ischemia (HI) brain injury have not been reported. Results: Up-regulation of CYGB reduces HI injury and improves long term cognitive impairment after neonatal HI. Conclusion: CYGB exhibits neuroprotective effects, possibly through antioxidant and antiapoptotic functions as well as by stimulating angiogenesis. Significance: These results provide a novel target for developing a clinically relevant strategy for future studies.
Aim: Neonatal respiratory distress syndrome (NRDS) is one of the most common and severe diseases in neonatal intensive care units worldwide. Increasing evidence suggests that lung ultrasound (LUS) may be a reliable diagnostic tool for neonatal respiratory distress syndrome. The aim of study was to evaluate the diagnostic accuracy of LUS for NRDS with a systematic review and meta-analysis. Material and methods: We searched for articles in EMBASE, PubMed and Cochrane Central from inception until 17 August 2019. The selected studies were diagnostic accuracy studies that reported the utility of LUS in the diagnosis of NRDS. Two researchers independently extracted data and assessed quality using the QUADAS-2 tool. Then, we created a bivariate mixed effects model to calculate the sensitivity and specificity of LUS in diagnosing NRDS. A summary receiver operator characteristic (SROC) curve was constructed to summarize the performance characteristics of LUS. Results: Nine studies involving 703 infants were included in the review. LUS had a pooled sensitivity of 0.99 (CI: 0.92-1.00) and a specificity of 0.95 (CI: 0.87-0.98). The areas under the curve for LUS was 0.99 (0.98-1.0). Meta-regression revealed that LUS had a significant diagnostic accuracy for NRDS. Conclusion: LUS is a promising method that is easily carried out, inexpensive, nonionizing and repeatable and can be performed at the bedside. Current evidence supports LUS as a useful imaging alternative for the diagnosis of NRDS.
Objective Transient tachypnoea of the newborn (TTN) is one of the most common causes of neonatal respiratory distress (RD) during the newborn period. Chest radiography (CXR) is commonly used to rule out the diagnosis, but TTN is often misdiagnosed as neonatal respiratory distress syndrome (NRDS) on the basis of CXR alone. Increasing evidence suggests that lung ultrasound (LUS) may be a reliable diagnostic tool for transient tachypnoea of the newborn. However, studies of the diagnostic efficiency of LUS are still lacking. This study was aimed to evaluate the accuracy and reliability of LUS for diagnosing TTN by conducting a systematic review and meta-analysis.
Study Design We searched for articles in the Embase, PubMed, and Cochrane Library databases from inception until May 31, 2020. The selected studies were diagnostic accuracy studies that reported the utility of LUS in the diagnosis of TTN. Two researchers independently extracted data and assessed quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Then, we created a bivariate model of mixed effects to calculate the sensitivity and specificity of LUS in diagnosing TTN. A summary receiver operator characteristic (SROC) curve was constructed to summarize the performance characteristics of LUS.
Results Six studies involving 617 newborns were included in the review. LUS had a pooled sensitivity of 0.98 (confidence interval [CI]: 0.92–1.00) and a specificity of 0.99 (CI: 0.91–1.00). The area under the curve for LUS was 1.00 (0.98–1.0). Meta-regression revealed that LUS had a significant diagnostic accuracy for TTN.
Conclusion The performance of ultrasound for the detection of TTN was excellent. Considering the various advantages of LUS compared with chest radiographs in diagnosing TTN, this study supports the routine use of LUS for the detection of TTN.
Key Points
With the improvement in survival rates of low-birthweight and very premature infants, neonatal fungal infection, especially fungal pneumonia, is becoming more and more common, but the diagnosis is always challenging. Recently, lung ultrasound (LUS) has been used to diagnose pneumonia in newborn infants, but not fungal pneumonia. This paper summarizes the ultrasonographic features of seven cases of neonatal fungal pneumonia, such as lung consolidation with air bronchograms, shred signs, lung pulse, pleural line abnormalities, and different kinds of B-lines. It was confirmed that LUS plays an important role in the diagnosis of fungal pneumonia in newborn infants.
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