Bronchoalveolar lavage under ultrasound monitoring of lungs for the treatment of neonatal atelectasis and lung consolidation

Abstract

Neonatal atelectasis and pulmonary consolidation diseases are common and difficult to treat. Thus, novel treatment methods need to be explored. Although an X-ray chest radiography is feasible for the detection of neonatal atelectasis and pulmonary consolidation diseases, there is a risk of radiation damage and lung ultrasound may be used instead. The aim of the present study was to investigate the bronchoalveolar lavage (BAL) under ultrasound monitoring of lungs for the treatment of neonatal atelectasis and lung consolidation disease. For this purpose, the present study prospectively selected 73 children with severe newborn respiratory distress syndrome (NRDS), 60 children with severe neonatal pneumonia (NP), and 65 children with meconium aspiration syndrome (MAS) as the research subjects. Each disease was divided into three groups as follows: The exogenous pulmonary surfactant (PS) lavage group, the normal saline (NS) lavage group and the non-lavage group, using lung ultrasound as the imaging method for lung disease. The treatment effect, complications and differences in the oxygenation index (OI) among the three groups of each disease were compared. The results revealed that the time of lung recruitment and invasive ventilator treatment among the three groups of each disease was shorter in the PS lavage group than in the NS lavage group, and also between the PS lavage and NS lavage group compared with the non-lavage group (P<0.05). Following treatment for each disease, the PS lavage group exhibited a more rapid decline in OI than the NS lavage group, and the PS lavage group and NS lavage group exhibited a more rapid decline in OI than the non-lavage group (P<0.05). No significant differences in treatment complications were observed among the three groups of each disease (P>0.05). On the whole, the present study demonstrates that BAL under lung ultrasound monitoring is effective in the treatment of neonatal atelectasis and pulmonary consolidation diseases caused by severe NRDS, severe NP or MAS. It can decrease the invasive ventilator treatment time of neonatal atelectasis and lung consolidation more rapidly, and can rapidly decrease the OI, without increasing complications. Thus, exogenous PS lavage is more effective than NS lavage.