Lung ultrasound decreased radiation exposure in preterm infants in a neonatal intensive care unit

Escourrou, Guillaume; Luca, Danièle De

doi:10.1111/apa.13369

Cited by 90 publications

(81 citation statements)

References 11 publications

(16 reference statements)

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“…This is consistent with previous data showing significant correlations between LUS and both the amount and quality of surfactant, as measured with a count of lamellar bodies and an adsorption test, respectively [24]. Thus, repeated LUS scans might be useful to follow up patients and reduce radiation exposure [26]. …”

Section: Discussionsupporting

confidence: 91%

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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Section: Discussionsupporting

confidence: 91%

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Raimondi

Yousef

Fanjul³

et al. 2019

Neonatology

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“…At present, severity of RDS can only be determined clinically using a combination of FiO 2 to maintain normal saturations, coupled with judgement of work of breathing and degree of aeration of the lungs on chest X-ray, all of which can be influenced by CPAP. Lung ultrasound may be a useful adjunct to clinical decision making in experienced hands, with RDS lungs having a specific appearance that can be differentiated from other common neonatal respiratory disorders [73] and it has potential to reduce X-ray exposure [74]. Rapid bedside tests to accurately determine presence or absence of surfactant in gastric aspirate are currently being tested in clinical trials [75].…”

Section: Surfactant Therapymentioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. We report the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

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“…We demonstrated that launching a LUS program in their neonatal intensive care unit (NICU) roughly halved the number of chest radiograms and significantly decreased the mean radiation dose/patient. 3 We present a comprehensive review on LUS in neonatology with an emphasis on pathophysiology and on a classification into descriptive (qualitative) and functional (semiquantitative) applications.…”

Section: Introductionmentioning

confidence: 99%

Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications

et al. 2018

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Lung ultrasound (LUS) is the latest amongst imaging techniques: it is a radiation-free, inexpensive, point-of-care tool that the clinician can use at the bedside. This review summarises the rapidly growing scientific evidence on LUS in neonatology, dividing it into descriptive and functional applications. We report the description of the main ultrasound features of neonatal respiratory disorders and functional applications of LUS aiming to help a clinical decision (such as surfactant administration, chest drainage etc). Amongst the functional applications, we propose SAFE (Sonographic Algorithm for liFe threatening Emergencies) as a standardised protocol for emergency functional LUS in critical neonates. SAFE has been funded by a specific grant issued by the European Society for Paediatric Research. Future potential development of LUS in neonatology might be linked to its quantitative evaluation: we also discuss available data and research directions using computer-aided diagnostic techniques. Finally, tools and opportunities to teach LUS and expand the research network are briefly presented.

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Lung ultrasound decreased radiation exposure in preterm infants in a neonatal intensive care unit

Cited by 90 publications

References 11 publications

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications

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