Lung ultrasound in early diagnosis of neonatal transient tachypnea and its differentiation from other causes of neonatal respiratory distress

Omran, Ahmed; AbdAllah, Nouran B.; Ibrahim, Mohammed Ahmed; El-Sharkawy, Sonya

doi:10.3233/npm-181796

Cited by 31 publications

(30 citation statements)

References 18 publications

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“…A significant correlation was observed between LUS scores and PEEP levels (ρ ¼ 0.782; p < 0.001). When we compared the LUS scores of preterm infants in terms of CPAP failure and nonfailure, a significantly higher LUS score was observed in patients with CPAP failure (CPAP nonfailure LUS score 4 [1][2][3][4][5][6]; CPAP failure LUS score 9 [8][9][10][11][12]; p < 0.001). LUS scores predict the CPAP failure accurately.…”

Section: Resultsmentioning

confidence: 99%

“…11 Moreover, LUS shows better diagnostic accuracy than CXR in some critical conditions and has been successfully adapted in NICUs for the diagnosis of several diseases such as RDS, transient tachypnea of the newborn, pneumonia, meconium aspiration syndrome, and pneumothorax. 12,13 Repeated CXRs are often needed in the diagnosis and follow-up of these diseases but carries the risk of IR exposure. 13,14 Escourrou and De Luca speculated that the use of LUS could reduce the risk of IR exposure.…”

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confidence: 99%

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The Role of Lung Ultrasound as an Early Diagnostic Tool for Need of Surfactant Therapy in Preterm Infants with Respiratory Distress Syndrome

2020

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Objective This study aimed to determine the accuracy of neonatal lung ultrasound (LUS) in predicting the need for surfactant therapy compared with chest X-ray (CXR) in preterm infants. Study Design A prospective double-blind study was conducted in infants with a gestational age <34 weeks with respiratory distress syndrome (RDS) by evaluation with LUS and CXR on admission. Results Among 45 preterm infants, the median (interquartile range [IQR]) LUS score was 4 (2–8) in the mild RDS group, whereas it was 10 (IQR: 9–12) in the severe RDS group (p < 0.01). The LUS score showed a significant correlation with the need for total surfactant doses (ρ = 0.855; 95% confidence interval [CI]: 0.801–0.902; p < 0.001). A cut-off LUS score of four predicted the need for surfactant with 96% sensitivity and 100% specificity (area under the curve [AUC]: 1.00; 95% CI: 0.97–1.00; p < 0.01). LUS scores predicted continuous positive airway pressure (CPAP) failure accurately (AUC: 0.804; 95% CI: 0.673–0.935; p = 0.001). A significant correlation was observed between LUS scores and positive end-expiratory pressure levels (ρ = 0.782; p < 0.001). During the study period, the CXR number per infant with RDS decreased significantly when compared with preceding months (p < 0.001). The LUS score in the first day of life did not predict the development of bronchopulmonary dysplasia (AUC: 0.274; 95% CI: 0.053–0.495; p = 0.065). Conclusion The LUS score in preterm infants accurately predicts the severity of RDS, the need for surfactant and CPAP failure. The routine use of LUS can decrease the frequency of CXRs in the neonatal intensive care units. Key Points

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

The Role of Lung Ultrasound as an Early Diagnostic Tool for Need of Surfactant Therapy in Preterm Infants with Respiratory Distress Syndrome

2020

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“…To date, several studies have been published assessing the clinical usefulness of lung ultrasound in newborns with respiratory disorders [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. These works focused mainly on preterm infants with RDS and transient tachypnea of the newborn (TTN); in both cases, LUS was performed primarily on the rst day of life.…”

Section: Discussionmentioning

confidence: 99%

A Modified Lung Ultrasound Score for Assessing Oxygenation Status and Predicting the Need for Invasive Ventilation in Preterm Neonates with RDS

Szymański¹,

Kruczek²,

Hożejowski³

et al. 2020

Preprint

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PurposeWe propose a modified lung ultrasound score (LUS) in neonates with respiratory distress syndrome (RDS), which includes posterior instead of lateral lung fields, and a 5-grade rating scale instead of a 4-grade rating scale. The LUS was evaluated for validity, interrater agreement and prognostic power in relation to the need for respiratory support on day of life (DOL) 3. The hypothesis of the dominant weight of posterior scans in the LUS was also verified.Materials and methodsA total of 647 serial lung scans were performed in 70 preterm infants <32 weeks gestation and birth weight <1500 g. Assessments were performed within 24 hours of birth (LUS0) and on days 2, 3, 5, 7, 10, 14, 21 and 28. LUS was correlated to oxygen saturation over fraction of inspired oxygen (SpO2/FiO2) and mode of respiratory support. Probabilities of the need for respiratory support on DOL 3 were assessed with ordinal logistic regression.ResultsThe LUS correlated significantly with SpO2/FiO2 (Spearman rho = -0.635; p<0.0001) and had excellent interrater agreement (Cronbach’s alpha = 0.99). Posterior fields had dominant weight over the anterior fields (ls mean [confidence level]) 4.0 [3.8–4.1] vs 2.2 [2.0–2.4]; p<0.0001. Significant predictors of ventilation requirements on DOL 3 were LUS0 (p<0.016) and birth weight (BW) (p<0.0001); invasive ventilation was the most likely option with LUS0 ≥7 (BW 900 g), ≥10 (BW 1050 g) and ≥15 (BW 1280 g).ConclusionPostbirth LUS predicts the need for mechanical ventilation on DOL 3. Posterior fields play a dominant role in sonographic assessment of lungs in neonatal RDS.

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“…Lung ultrasound (LUS), as a simple and non-invasive diagnostic technique with no exposure to ionizing radiation, can be used as a reliable diagnostic tool for causes of neonatal respiratory distress with good sensitivity and specificity, as reported in a literature review (Sharma and Farahbakhsh 2019). It can be used not only for early diagnosis of transient tachypnea of newborn (TTN) but also Lung ultrasound score can be used for predicting the clinical course of the disease and monitoring lung aeration (Ibrahim et al 2018;Raimondi et al 2019). Another uses for LUS includes diagnosis of congenital diaphragmatic hernia, if prenatal diagnosis is missed, and diagnosis of pulmonary hemorrhage of newborn (Ren et al 2017;Corsini et al 2019).…”

Section: Introduction and Rationalementioning

confidence: 99%

“…LUS can be used in diagnosis of RDS complication with better detection, compared to Chest X-ray, of consolidation and sub-pleural atelectasis (Lovrenski et al 2015;Sawires et al 2015;Ibrahim et al 2018). It can be used also in follow up and early assessment of the response to surfactant replacement therapy (El-Malah et al 2015;Lovrenski et al 2015).…”

Section: Introduction and Rationalementioning

confidence: 99%

Neonatology research protocol

2020

Medicine Updates

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Lung ultrasound in early diagnosis of neonatal transient tachypnea and its differentiation from other causes of neonatal respiratory distress

Abstract: We found LUS to be a reliable and non-invasive tool for the early diagnosis of TTN and its differentiation from other causes of neonatal RD in near and full term Egyptian neonates.

Cited by 31 publications

References 18 publications

The Role of Lung Ultrasound as an Early Diagnostic Tool for Need of Surfactant Therapy in Preterm Infants with Respiratory Distress Syndrome

The Role of Lung Ultrasound as an Early Diagnostic Tool for Need of Surfactant Therapy in Preterm Infants with Respiratory Distress Syndrome

A Modified Lung Ultrasound Score for Assessing Oxygenation Status and Predicting the Need for Invasive Ventilation in Preterm Neonates with RDS

Neonatology research protocol

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