The diagnostic value of pulmonary near‐infrared spectroscopy in the early distinction of neonatal pneumonia from transient tachypnea of the newborn

Abstract

AimPulmonary near‐infrared spectroscopy (NIRS) is a new and promising tool for diagnosis of neonatal respiratory diseases (RD). The study aimed to determine the role of pulmonary regional oxygen saturation (pRSO2) values obtained by NIRS in the early distinction of neonatal pneumonia (NP) from transient tachypnea of the newborn (TTN).MethodsThis prospective, observational, double‐blind study was conducted in neonatal intensive care unit (NICU) between 2020 and 2021. Late preterm and term newborns hospitalized in the NICU due to the diagnosis of TTN and NP were included. Cerebral RSO2 and pRSO2 values were measured during the 1st, 24th, 48th, and 72nd hours of hospitalization, using NIRS.ResultsOf the eligible 40 infants, 65% (n: 26) were diagnosed as TTN and 35% (n: 16) as NP. The pRSO2 values were significantly higher in the TTN group than the NP group for both apexes (75.3 ± 8.7 vs. 69 ± 5.4, p: .018, respectively) and lateral lung (77.8 ± 6 vs. 72.7 ± 6.2, p: .016, respectively) in the 1st hour of hospitalization. There were significant differences in pRSO2apex and pRSO2lateral values between the 1st and 24th hours of hospitalization and the 24th and 48th hours in the NP group (p2: .001 for both). The optimal pRSO2apex cut‐off value was >72% to predict the diagnosis of NP with a sensitivity of 78.6% and a specificity of 69.2%.ConclusionPulmonary NIRS may be considered as a feasible and promising diagnostic tool in late preterm and term infants with RD. It may also be helpful for the early differentiation of NP from TTN and the courses of these diseases.

Noninvasive Monitoring Strategies for Bronchopulmonary Dysplasia or Post-Prematurity Respiratory Disease: Current Challenges and Future Prospects

“…The rSO 2 values were significantly higher in infants with transient tachypnea (TTN) than in neonatal pneumonia. The authors proposed a cut-off value to distinguish the two neonatal diseases [52]. Furthermore, rSO 2 L values at the end of the first hour of life in the TTN group were very similar to the levels of a healthy newborn in the 3rd minute of life in the previous study.…”

“…In the light of these findings, recently a single-centre prospective, observational, double-blind study of 40 late preterm and term infants diagnosed with neonatal respiratory disease was conducted in Turkey [52]. Lung rSO 2 values by NIRS monitoring were measured during the 1st, 24th, 48th, and 72nd hours of hospitalisation in the NICU.…”