Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

Corsini, Iuri; Parri, Niccolò; Gozzini, Elena; Coviello, Caterina; Leonardi, Valentina; Poggi, Chiara; Giacalone, Martina; Bianconi, Tommaso; Tofani, Lorenzo; Raimondi, Francesco; Dani, Carlo

doi:10.1159/000493001

Cited by 89 publications

(113 citation statements)

References 23 publications

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“…It can be used to predict the need for respiratory support in the first hours of life or the need for surfactant administration in preterm infants . LU is reproducible and reduces the number of thoracic X‐rays performed in the NICU . It is increasingly recognized as a useful tool in very low birth weight infants (VLBWI) with BPD.…”

Section: Introductionmentioning

confidence: 99%

Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants

Alonso‐Ojembarrena

Lubián‐López

2019

Pediatric Pulmonology

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Background Lung ultrasound (LU) has been widely used to diagnose and monitor acute lung diseases in neonates, but its role in chronic diseases has not been elucidated. Objective We aim to describe the evolution of a lung ultrasound score (LU score) in very low birth weight infants (VLBWI) with and without bronchopulmonary dysplasia (BPD). Methods We prospectively included 59 VLBWI and performed LU in the first 24 and 72 hours of life, and then weekly until 36 weeks´ postmenstrual age (PMA). We calculated the LU score as a semiquantitative score representing the aeration (0‐3) in three different areas of each lung. Results The non‐BPD group (n = 38) had lower LU score at 1, 2, 3, 4, and 36 weeks' PMA than the BPD group: median score of 1 (0‐4) vs 7 (3‐10), P < .001; 0 (0‐1) vs 7 (4‐9), P < .001; 0 (0‐1) vs 8 (7‐11), P < .001; 0 (0‐2) vs 9 (4‐12), P < .001; 0 (0‐0) vs 3 (0‐6), P < .001. A LU score of 5 or above at 1 week of life predicted BPD with a sensitivity (Se) of 71%, specificity (Sp) 80%, area under the ROC curve (AUC) 0.8, and at 2 weeks of life with Se 74%, Sp 100%, and AUC 0.93. An LU score of 4 or above at 4 weeks predicted moderate‐severe BPD (Se 100%, Sp 80%, and AUC 0.89). Conclusion In VLBWI without BPD, LU score increases during the first week of life and decreases thereafter, whereas among subjects with BPD, the LU score remains high until 36 weeks´ PMA. LU score can predict the diagnosis of BPD at 1 week and 2 weeks of life, and may predict moderate‐severe BPD at 4 weeks of life.

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Section: Introductionmentioning

confidence: 99%

Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants

Alonso‐Ojembarrena

Lubián‐López

2019

Pediatric Pulmonology

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“…Lung ultrasound is subjective in nature. Studies have demonstrated a high inter‐observer agreement among clinicians trained in lung ultrasound, independent of the clinicians' levels of experience . Further research is needed to determine whether there is agreement between different centres with varying ultrasound equipment.…”

Section: Resultsmentioning

confidence: 99%

“…Schmölzer (2012) 7 Compares respiratory function monitoring guided resuscitation to clinical assessment 49 Respiratory function monitoring results in less mask leaks and decreased use of excessive tidal volumes.…”

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confidence: 99%

“…Lung ultrasound has a high sensitivity and specificity for the diagnosis of RDS when compared to clinical diagnosis and chest X-ray Brat (2015) 42 De Martino (2018) 41 Perri (2018) 47 Lung ultrasound score to predict SRT 319 High-risk lung ultrasound scores are accurate at predicting SRT in premature neonates 43 Correlation between lung ultrasound scores and oxygenation 75 Lung ultrasound scores are well correlated to multiple oxygenation indices Brusa (2015) 48 Corsini (2019) 49 Inter-observer agreement 238 Lung ultrasound has high inter-observer agreement between interpreters with different levels of experience Rodriguez-Fanjul(2016) 45 Lung ultrasound score to predict mechanical ventilation 159 High-risk lung ultrasound scores are accurate at predicting mechanical ventilation in premature neonates (Continues) ultrasound is an increasingly researched tool, and many studies have evaluated its use in neonates with RDS.…”

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confidence: 99%

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Tools to assess lung aeration in neonates with respiratory distress syndrome

et al. 2019

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Aim Respiratory distress syndrome is a common condition among preterm neonates, and assessing lung aeration assists in diagnosing the disease and helping to guide and monitor treatment. We aimed to identify and analyse the tools available to assess lung aeration in neonates with respiratory distress syndrome. Methods A systematic review and narrative synthesis of studies published between January 1, 2004, and August 26, 2019, were performed using the OVID Medline, PubMed, Embase and Scopus databases. Results A total of 53 relevant papers were retrieved for the narrative synthesis. The main tools used to assess lung aeration were respiratory function monitoring, capnography, chest X‐rays, lung ultrasound, electrical impedance tomography and respiratory inductive plethysmography. This paper discusses the evidence to support the use of these tools, including their advantages and disadvantages, and explores the future of lung aeration assessments within neonatal intensive care units. Conclusion There are currently several promising tools available to assess lung aeration in neonates with respiratory distress syndrome, but they all have their limitations. These tools need to be refined to facilitate convenient and accurate assessments of lung aeration in neonates with respiratory distress syndrome.

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“…24 Clinicians could use the information obtained from LUS to help them decide to apply an exogenous surfactant without further deterioration of oxygenation. 6,7 Despite the widespread use of LUS in the diagnosis and management of lung diseases, no study in the literature has compared the effectiveness of different surfactants using LUS screening. In a study by Gargani et al, 25 parenchymal abnormalities that were determined by LUS preceded FiO 2 changes in an ARDSinduced animal model.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Different Types of Natural Surfactants by Lung Ultrasound in Respiratory Distress Syndrome

et al. 2019

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Objective To compare the lung ultrasonography (LUS) scores after two different natural surfactant administration as a parameter reflecting lung inflation. Study Design Preterm infants of 32 gestational weeks and below who were diagnosed with respiratory distress syndrome (RDS) were randomly assigned to be administered either poractant alfa or beractant, prospectively. Serial LUS scans were obtained by an experienced neonatologist in a standardized manner before and after (2 and 6 hours) surfactant administration. The LUS scans were evaluated by protocols based on scores and lung profiles. Results Thirty-seven infants received poractant alfa and 36 received beractant. The baseline characteristics and presurfactant LUS scores were similar in groups. The scores were significantly decreased after surfactant administration in both groups (2 hours, p = < 0.001; 6 hours, p = < 0.001). LUS scores in poractant group were significantly lower than beractant group when compared at each time point. At the end of 6 hours, the number of infants with the normal profile was significantly higher in the poractant group (∼65%) than the beractant group (22%). Conclusion LUS is beneficial for evaluating lung aeration after surfactant treatment in preterm infants with RDS. A better lung aeration can be achieved in the early period with the use of poractant alfa.

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Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

Cited by 89 publications

References 23 publications

Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants

Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants

Tools to assess lung aeration in neonates with respiratory distress syndrome

Evaluation of Different Types of Natural Surfactants by Lung Ultrasound in Respiratory Distress Syndrome

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