Lung Ultrasound in the Evaluation of Neonatal Respiratory Distress Syndrome

Abstract

Objective The purpose of this study is to examine the impact of bedside lung ultrasound (LUS) and LUS scores in the evaluating and grading of neonatal respiratory distress syndrome (NRDS). Methods We performed a prospective study on 80 children with suspected NRDS. Infants with a PaO2‐to‐FiO2 ratio of <200, 200–300, and >300 mmHg were categorized as the “severe‐NRDS group,” “mild‐NRDS group,” and “non‐NRDS group,” respectively. Left and right lungs were divided into six areas, respectively. For each lung area, a 0‐ to 3‐point score was given. Results The most common ultrasonic signs of NRDS include bilateral coalescent B‐lines, thickened pleural line, and white lung without spared areas. Moreover, different LUS scores among non‐NRDS, mild‐NRDS, and severe‐NRDS groups were identified (6.00 ± 4.033, 25.82 ± 3.778 and 27.90 ± 4.071, respectively; P < .05). When the cutoff value of LUS score was selected as 13 for the differentiation of non‐NRDS from NRDS, the sensitivity and specificity were 96.9% and 93.3%, respectively, and the area under the curve (AUC) of receiver operating characteristics (ROC) was 0.938 (95% confidence interval [CI], 0.84–1.00). With a cutoff value of 26.5 for the differentiation between mild‐ and severe‐ARDS, the AUC of ROC curve of the LUS score was 0.707 (95% CI, 0.58–0.83). Similar results were revealed as those with chest X‐ray. Conclusion This study showed that LUS and LUS scores complement each other, and are highly reliable and efficient in bedside radiological diagnostic investigations in newborns with NRDS.

Feasibility of ultrasound in the diagnosis of neonatal respiratory distress syndrome in preterm infants

“…Given that normal lungs are filled with gas, ultrasonic waves that encounter this gas cause total reflection. Thus, the feasibility of lung ultrasound examination in NRDS has constantly been a research concern [ 7 , 8 ]. With the development and maturity of ultrasound technology, lung ultrasound has been applied in the evaluation of the curative effects, especially in the field of intensive medicine.…”

Letter Regarding “Lung Ultrasound in the Evaluation of Neonatal Respiratory Distress Syndrome”

“…To the Editor: We read the recent study 1 on the utilization of lung ultrasound (LUS) in evaluating neonatal respiratory distress syndrome with great interest. The research presented in this article offers valuable insights into the potential of this imaging technique for managing this critical condition.…”

AIUM Official Statement: Statement and Recommendations for Safety Assurance in Lung Ultrasound

“…In addition to the older methods for pulmonary effusion and thoracentesis, LUS has been found to be valuable in the diagnosis of pneumonia, pulmonary edema, pulmonary embolism, atelectasis, diffuse parenchymal disease, respiratory distress syndrome, COVID‐19, and lung cancer 1–4 . Lung ultrasound is particularly valuable in neonates at the point‐of‐care (POC) for diagnosis of respiratory distress syndrome, 5 assessing surfactant treatment, 6 pulmonary hemorrhage, 7 and the number of B lines correlates with computed tomography findings, 8 while avoiding any ionizing radiation exposure. An international review provides guidelines and 20 consensus statements on the use of LUS 9 .…”

“…An international review provides guidelines and 20 consensus statements on the use of LUS 9 . Neonatal POC LUS has been found to be valuable in many patient settings, and is often routinely performed daily to follow patient progress 5,6 . Neonatal exam guidelines noted the use of 10–15 MHz linear arrays at 10–12 positions on the neonatal chest, at birth and each week (ie, totaling 40–48 individual exams for scoring) 10 .…”

“…9 Neonatal POC LUS has been found to be valuable in many patient settings, and is often routinely performed daily to follow patient progress. 5,6 Neonatal exam guidelines noted the use of 10-15 MHz linear arrays at 10-12 positions on the neonatal chest, at birth and each week (ie, totaling 40-48 individual exams for scoring). 10 Use of presets was recommended if available with adjustment of parameters to recommended settings.…”