Neonatal Lung Sonography

Brusa, Giacomo; Savoia, Marilena; Vergine, Michela; Bon, Andrea; Copetti, Roberto; Cattarossi, Luigi

doi:10.7863/ultra.15.14.08016

Cited by 56 publications

(19 citation statements)

References 24 publications

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“…The high level of agreement between LUS and CXR, even in operators with different levels of training, suggests that LUS could be used in routine clinical practice to overcome the main limitation of previous studies in which LUS was performed by a single experienced sonographer. On the other hand, our findings are consistent with those of Brusa et al [22], who previously demonstrated that LUS has high interobserver agreement, even between sonographers with different levels of experience.…”

Section: Discussionsupporting

confidence: 83%

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

et al. 2018

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Background: Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking. Objective: To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life. Methods: We enrolled newborns with RD during the first 24 h of life. Patients underwent LUS and CXR. LUS and CXR diagnosis were compared to evaluate concordance. Twenty percent of patients received two LUS (one from an experienced and one from a novice sonographer) to calculate the interobserver agreement. The difference in time needed to reach a diagnosis with LUS and CXR, and from novice and expert operators, was measured. Results: We studied 124 patients; 134 diagnoses were reported. The concordance between LUS and CXR diagnosis was 91% (95% CI 86–96%) with a κ statistic of 0.88 (95% CI 0.81–0.94). The median time to diagnosis was shorter for LUS (9.5 min, IQR 5–15) than for CXR (50 min, IQR 33–64) (p < 0.0001). In 25/124 patients, LUS was performed by both novice and experienced sonographers with complete concordance. The median time to diagnosis was shorter for expert (9 min, IQR 5–15) than novice operators (15 min, IQR 10–20) (p < 0.0002). Conclusion: LUS and CXR have a high concordance in the differential diagnosis of neonatal RD in the first 24 h of life. LUS has a shorter operation time than CXR.

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Section: Discussionsupporting

confidence: 83%

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

et al. 2018

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“…The neonatologists involved in the study were trained in LUS technique and data could be worse for novice. However, it was demonstrated that LUS learning curve is quite short [ 14 ] and even beginner operators had high reliability in neonatal diagnosis when compared with experienced one [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound Diagnostic Accuracy in Neonatal Pneumothorax

Cattarossi

Copetti

Brusa

et al. 2016

Canadian Respiratory Journal

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Background. Pneumothorax (PTX) still remains a common cause of morbidity in critically ill and ventilated neonates. At the present time, lung ultrasound (LUS) is not included in the diagnostic work-up of PTX in newborns despite of excellent evidence of reliability in adults. The aim of this study was to compare LUS, chest X-ray (CXR), and chest transillumination (CTR) for PTX diagnosis in a group of neonates in which the presence of air in the pleural space was confirmed. Methods. In a 36-month period, 49 neonates with respiratory distress were enrolled in the study. Twenty-three had PTX requiring aspiration or chest drainage (birth weight 2120 ± 1640 grams; gestational age = 36 ± 5 weeks), and 26 were suffering from respiratory distress without PTX (birth weight 2120 ± 1640 grams; gestational age = 34 ± 5 weeks). Both groups had done LUS, CTR, and CXR. Results. LUS was consistent with PTX in all 23 patients requiring chest aspiration. In this group, CXR did not detect PTX in one patient while CTR did not detect it in 3 patients. Sensitivity and specificity in diagnosing PTX were therefore 1 for LUS, 0.96 and 1 for CXR, and 0.87 and 0.96 for CTR. Conclusions. Our results confirm that also in newborns LUS is at least as accurate as CXR in the diagnosis of PTX while CTR has a lower accuracy.

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“…Gomond-Le Goff et al [ 32 ] achieved good inter-rater agreement results independent of the raters' experience by retrospectively rating still images of LUS that had been performed in critically ill neonates. In another study similar to ours, four raters with different levels of experience retrospectively interpreted videoclips taken from 114 neonates with respiratory distress, and the physicians with different levels of experience were able to achieve good interobserver agreement [ 33 ]. Gullett et al [ 34 ] evaluated the agreement among emergency physicians with different levels of experience with regard to findings in different lung zones.…”

Section: Discussionmentioning

confidence: 97%

Lung ultrasonography in pregnant women during the COVID-19 pandemic: an interobserver agreement study among obstetricians

Yassa¹,

Mutlu²,

Birol³

et al. 2020

Ultrasonography

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Purpose: This study investigated interobserver agreement in lung ultrasonography (LUS) in pregnant women performed by obstetricians with different levels of expertise, with confirmation by an expert radiologist. Methods: This prospective study was conducted at a tertiary "Coronavirus Pandemic Hospital" in April 2020. Pregnant women suspected to have coronavirus disease 2019 (COVID-19) were included. Two blinded experienced obstetricians performed LUS on pregnant women separately and noted their scores for 14 lung zones. Following a theoretical and hands-on practical course, one experienced obstetrician, two novice obstetric residents, and an experienced radiologist blindly evaluated anonymized and randomized still images and videoclips retrospectively. Weighted Cohen's kappa and Krippendorff's alpha tests were used to assess the interobserver agreement. Results: Fifty-two pregnant women were included, with confirmed COVID-19 diagnosis rate of 82.7%. In total, 336 eligible still images and 115 videoclips were included in the final analysis. The overall weighted Cohen's kappa values ranged from 0.706 to 0.912 for the 14 lung zones. There were only seven instances of major disagreement (>1 point) in the evaluation of 14 lung zones of 52 patients (n=728). The overall agreement between the radiologist and obstetricians for the still images (Krippendorff's α=0.856, 95% confidence interval [CI], 0.797 to 0.915) and videoclips (Krippendorff's α=0.785; 95% CI, 0.709 to 0.861) was good. Conclusion: The interobserver agreement between obstetricians with different levels of experience on still images and videoclips of LUS was good. Following a brief theoretical course, obstetricians' performance of LUS in pregnant women and interpretation of pre-acquired LUS images can be considered consistent.

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Neonatal Lung Sonography

Abstract: In neonates with early respiratory distress, lung sonography has high interobserver agreement even between interpreters with varying levels of experience.

Cited by 56 publications

References 24 publications

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

Lung Ultrasound Diagnostic Accuracy in Neonatal Pneumothorax

Lung ultrasonography in pregnant women during the COVID-19 pandemic: an interobserver agreement study among obstetricians

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