Lung Ultrasound for the Diagnosis of Neonatal Respiratory Distress Syndrome

Abstract

Chest radiography is the primary imaging modality used for the assessment of neonatal respiratory distress syndrome (NRDS) in newborns. However, excessively exposing a growing neonate to harmful ionizing radiation may have long-term consequences. Some studies have shown that lung ultrasound (LUS) is helpful in the diagnosis of NRDS. A comprehensive search was carried out using PubMed, Embase, and the Cochrane Library to identify studies in which newborns with clinically suspected NRDS were assessed by LUS. Two investigators independently screened the literature and extracted the data. Any discrepancies were resolved via discussion with the senior author. Study quality was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool, and pooled sensitivity and specificity of various LUS findings for diagnosing NRDS were determined. Summary receiver operating characteristic curve was used to assess the overall performance of LUS. Ten studies with a total of 887 neonates were included in this meta-analysis. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for the diagnosis of NRDS using LUS were 0.92 (95% confidence interval [CI], 0.89-0.94), 0.95 (95% CI, 0.93-0.97), 20.23 (95% CI, 8.54-47.92), 0.07 (95% CI, 0.03-0.14), and 455.30 (95% CI, 153.01-1354.79), respectively. Furthermore, the summary receiver operating characteristic area under the curve was calculated to be 0.9888. The main LUS characteristics of NRDS include bilateral white lung, pleural line abnormalities, and lung consolidation. In summary, LUS is a highly valuable diagnostic technology that complements chest radiography in the diagnosis and follow-up monitoring of NRDS.

Lung Volume Head Ratio: A Potential Parameter for Prediction of Respiratory Distress in Newborn

“…Ultrasound might also be used for diagnosis and management of RD in newborn , in the metaanalysis by Ma et al , chest X ray with lung ultrasound (LUS) were compared and LUS was advantageous over Chest x ray 13 .…”

Lung ultrasound as a non‐invasive tool for respiratory distress syndrome

“…We would like to highlight the utility of ultrasound as a non-invasive in the diagnosis and follow-up of respiratory distress syndrome (RDS) 2,3 in the similar settings as that of Hedstrom et al 1 The main lung ultrasound (LUS) characteristics of RDS are bilateral white lung, pleural line abnormalities and lung consolidation. 3 Ahuja et al conducted a study in 88 premature infants using transabdominal ultrasound of lung bases (TASL) and found 85.7% sensitivity, 75% specificity, 88.88% positive predictive value and 69.2% negative predictive value respectively of TASL for the diagnosis of RDS. 2 In a recent meta-analysis, 3 the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of RDS using LUS were shown to be 0.92 (95% Considering the excellent sensitivity and specificity of the LUS in the detection of RDS, 2,3 LUS can be used a point-of-care non-invasive modality so that the neonates requiring the surfactant can be identified early as well as unnecessary administration of the surfactant (which requires intubation) can be avoided.…”

“…3 Ahuja et al conducted a study in 88 premature infants using transabdominal ultrasound of lung bases (TASL) and found 85.7% sensitivity, 75% specificity, 88.88% positive predictive value and 69.2% negative predictive value respectively of TASL for the diagnosis of RDS. 2 In a recent meta-analysis, 3 the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of RDS using LUS were shown to be 0.92 (95% Considering the excellent sensitivity and specificity of the LUS in the detection of RDS, 2,3 LUS can be used a point-of-care non-invasive modality so that the neonates requiring the surfactant can be identified early as well as unnecessary administration of the surfactant (which requires intubation) can be avoided. Ultrasound examination has the added advantage of being non-invasive, does not involve any radiation and can be repeated bedside.…”

Ultrasound assessment of gastric emptying in premature infants treated with non-invasive ventilatory support

“…The LUS score is assigned based on observations reflecting the efficacy of aeration at 6 different lung fields [12]. A recent meta-analysis has validated it for assessing the severity of RDS with high sensitivity and specificity [11].…”