Lung Ultrasonography to Diagnose Transient Tachypnea of the Newborn

Liu, Jing; Chen, Xinxin; Li, Xiangwen; Chen, Shui-Wen; Wang, Yan; Fu, Wei

doi:10.1016/j.chest.2015.12.024

Cited by 100 publications

(95 citation statements)

References 16 publications

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“…Most patients in this group were diagnosed with TTN. We obtained a high specificity according to other series [9,21]. We took the double lung point as suggestive of TTN based on the 100% sensitivity reported by Copetti and Cattarossi [9], although Liu et al [22] published a sensitivity of 76.7% after our data had already been collected.…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

et al. 2016

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Background: The prognosis of neonatal respiratory distress may be difficult to estimate at admission. Lung ultrasound is a useful diagnostic tool that is quick, requires little training, and is radiation free. Objective: This study aims to analyze whether early lung ultrasound can predict respiratory failure. Methods: From January to December 2014, lung ultrasound was performed on neonates admitted with breathing difficulties if they were older than 32 weeks and not intubated. A neonatologist, not aware of the patient's clinical condition, analyzed the stored ultrasound images. The findings were classified into the following 2 groups according to the potential risk of a bad respiratory outcome: low risk (normal or transient tachypnea of the newborn) or high risk (respiratory distress syndrome, meconium aspiration syndrome, pneumothorax, or pneumonia). A second investigator made the same classification after reading the chest X-rays. Respiratory failure was defined as a need for mechanical ventilation during the first day of life. Results: In total, 105 neonates were recruited (64.8% in the low-risk sonography group and 35.2% in the high-risk sonography group). Of those, 20% needed intubation, and this was more frequent in the high-risk group (relative risk = 17.5; 95% CI 4.3-70.9, p < 0.01). As predictors of respiratory failure, lung ultrasound and chest X-ray showed a high index of agreement (κ coefficient = 0.91; 95% CI 0.83-1, p < 0.01) and good accuracy (ultrasound: 95% sensitivity, 82.5% specificity, and a negative predictive value of 98.5%). Conclusions: Early lung ultrasound is a useful tool to determine which neonates admitted with respiratory distress will require mechanical ventilation. It may help the clinician to carrying out appropriate transfers.

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Section: Discussionmentioning

confidence: 99%

Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

et al. 2016

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“…Considering α = 0.05, β = 0.80, and 75% sensitivity for DLP to diagnose TTN, a sample size of 62 neonates was needed. We chose a 75% sensitivity since this was an intermediate value between the 100% reported by Copetti et al [4] and the 45.6% found by Liu et al [6]. Interobserver agreement was calculated with Cohen’s κ coefficient.…”

Section: Methodsmentioning

confidence: 99%

“…The diagnostic accuracy of the DLP for TTN varies in studies published to date (sensitivity range 100–45.6% and specificity range 100–94.6%) [4, 5]. Moreover, TTN presentation at ultrasound is also variable, ranging from a “white lung” image to a benign pattern with a prevalence of A-lines [6, 7]. These different LUS findings might be quite confusing for the physician wishing to include LUS in the diagnostic process.…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Raimondi

Yousef

Fanjul³

et al. 2019

Neonatology

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Background and Aim: Discordant results that demand clarification have been published on diagnostic lung ultrasound (LUS) signs of transient tachypnea of the neonate (TTN) in previous cross-sectional, single-center studies. This work was conducted to correlate clinical and imaging data in a longitudinal and multicenter fashion. Methods: Neonates with a gestational age of 34–40 weeks and presenting with TTN underwent a first LUS scan at 60–180 min of life. LUS scans were repeated every 6–12 h if signs of respiratory distress persisted. Images were qualitatively described and a LUS aeration score was calculated. Clinical data were collected during respiratory distress. Results: We enrolled 65 TTN patients. Thirty-one (47.6%) had a sharp echogenicity increase in the lower lung fields (the “double lung point” or DLP sign). On admission, there was no significant difference between patients with and without DLP in Silverman scores (4 ± 1.5 vs. 4 ± 2.1; p = 0.9) or LUS scores (7.6 ± 2.6 vs. 5.6 ± 3.8; p = 0.12); PaO₂/FiO₂ (249 ± 93 vs. 252 ± 125; p = 0.91). All initial LUS scans (performed at the onset of distress) and 99.5% of all scans showed a regular pleural line with no consolidation, with only 1 neonate showing consolidation in the follow-up scans. The Silverman and LUS scores were significantly correlated (rho = 0.27; p = 0.02). Conclusion: A regular pleural line with no consolidation is a consistent finding in TTN. The presence of a DLP is not essential for the LUS diagnosis of TTN. A semi-quantitative LUS score correlates well with the clinical course and could be useful in monitoring changes in lung aeration during TTN.

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“…During late prgnancy, as a result of increased secretion of epinehrines and other hormones, the neonatal mature lung switches from secreting fluid into the air spaces to starting reabsorbing it [4,5].…”

Section: Introductionmentioning

confidence: 99%