Use of Neonatal Chest Ultrasound to Predict Noninvasive Ventilation Failure

Raimondi, Francesco; Migliaro, Fiorella; Sodano, Angela; Ferrara, Teresa; Lama, Sílvia Nassif Del; Vallone, Gianfranco; Capasso, Letizia

doi:10.1542/peds.2013-3924

Cited by 135 publications

(156 citation statements)

References 31 publications

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“…The accuracy of LUS in estimating the need for surfactant or respiratory support has already been analyzed [7,19,20]. In those studies, LUS was confirmed to be a good tool for prediction of the need for MV, being even better than chest X-rays [7].…”

Section: Discussionmentioning

confidence: 99%

“…In those studies, LUS was confirmed to be a good tool for prediction of the need for MV, being even better than chest X-rays [7]. …”

Section: Discussionmentioning

confidence: 99%

“…Raimondi et al [7] reported a higher rate of MV (100% of intubation in preterm infants with a white LUS pattern). Taking into consideration preterm infants only, this difference could be due to an NIV protocol that includes a wide interval of continuous positive airway pressures (up to 7-8 cm H 2 O) and nasal intermittent positive pressure ventilation.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Raimondi et al [7] reported their results using a white lung pattern as a predictor of noninvasive ventilation (NIV) failure in preterm infants with respiratory distress syndrome (RDS). Evaluation of LUS as a marker for prediction of the respiratory outcome may be useful for the clinician to prevent clinical deterioration and arrange appropriate transfers.…”

Section: Introductionmentioning

confidence: 99%

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Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

et al. 2016

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Background: The prognosis of neonatal respiratory distress may be difficult to estimate at admission. Lung ultrasound is a useful diagnostic tool that is quick, requires little training, and is radiation free. Objective: This study aims to analyze whether early lung ultrasound can predict respiratory failure. Methods: From January to December 2014, lung ultrasound was performed on neonates admitted with breathing difficulties if they were older than 32 weeks and not intubated. A neonatologist, not aware of the patient's clinical condition, analyzed the stored ultrasound images. The findings were classified into the following 2 groups according to the potential risk of a bad respiratory outcome: low risk (normal or transient tachypnea of the newborn) or high risk (respiratory distress syndrome, meconium aspiration syndrome, pneumothorax, or pneumonia). A second investigator made the same classification after reading the chest X-rays. Respiratory failure was defined as a need for mechanical ventilation during the first day of life. Results: In total, 105 neonates were recruited (64.8% in the low-risk sonography group and 35.2% in the high-risk sonography group). Of those, 20% needed intubation, and this was more frequent in the high-risk group (relative risk = 17.5; 95% CI 4.3-70.9, p < 0.01). As predictors of respiratory failure, lung ultrasound and chest X-ray showed a high index of agreement (κ coefficient = 0.91; 95% CI 0.83-1, p < 0.01) and good accuracy (ultrasound: 95% sensitivity, 82.5% specificity, and a negative predictive value of 98.5%). Conclusions: Early lung ultrasound is a useful tool to determine which neonates admitted with respiratory distress will require mechanical ventilation. It may help the clinician to carrying out appropriate transfers.

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Section: Discussionmentioning

confidence: 99%

“…In those studies, LUS was confirmed to be a good tool for prediction of the need for MV, being even better than chest X-rays [7]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

et al. 2016

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“…Complications of non-invasive ventilation are mainly pressure sores of skin around the nose, ulceration and necrosis of the septum, much less likely hyperinflation of the lungs, restlessness, PTX, stomach distension or food intolerance. Non-invasive ventilation failure may be predicted by the use of neonatal chest US [52].…”

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

Respiratory Care of the Neonate

Grosek¹,

Fister²

2018

Selected Topics in Neonatal Care

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The respiratory distress is a very common condition both in term and in preterm neonates and the most frequent reason for admission to the neonatal intensive care unit (NICU). The aetiology greatly depends on the maturation of neonate's organs and perinatal events. The clinical picture is sometimes scarce and very nonspecific for the etiologic determination. Treatment of neonatal RD begins first with the application of a mixture of oxygen and air, then with different modes of non-invasive respiratory support methods. Non-invasive respiratory support can be sustained with nasal continuous positive airway pressure, bi-level positive airway pressure and high-flow nasal cannula ventilation. Non-invasive ventilation with high-frequency oscillations through nasal cannula or masks is also possible with some respiratory devices. Non-invasive ventilation is usually combined with the application of natural surfactant and other therapeutic means, like methylxanthine therapy, prevention and closure of patent ductus arteriosus, and control of infection. In the case of non-invasive ventilation failure, different kinds of invasive ventilation methods are available and being practiced in NICUs. The invasive respiratory support can be maintained by controlled or intermittent mandatory ventilation combined with different supportive synchronous positive inspiratory ventilation, offered by modern respirators.

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Lung Ultrasonography Score to Evaluate Oxygenation and Surfactant Need in Neonates Treated With Continuous Positive Airway Pressure

et al. 2015

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IMPORTANCE Lung ultrasonography (LUS) is a bedside technique useful to diagnose neonatal respiratory problems, but, to our knowledge, no data are available about its use for monitoring lung function or eventually guiding surfactant therapy.OBJECTIVE To determine the diagnostic accuracy of a neonatal-adapted LUS score to evaluate oxygenation and predict need for surfactant administration. DESIGN, SETTING, AND PARTICIPANTSProspective diagnostic accuracy study following STARD (Standards for the Reporting of Diagnostic Accuracy Studies) guidelines at a tertiary level academic neonatal intensive care unit in 2014. All neonates admitted to the neonatal intensive care unit with signs of respiratory distress were eligible, and 130 neonates were enrolled. The LUS score was calculated in the first hours of life under continuous positive airway pressure. The transcutaneous partial pressure of oxygen (PtcO 2 ) to fraction of inspired oxygen (FiO 2 ) ratio, alveolar-arterial gradient, oxygenation index, and arterial to alveolar ratio were calculated within 30 minutes from LUS, using transcutaneous blood gas monitoring. Surfactant was administered according to 2013 European guidelines. MAIN OUTCOMES AND MEASURES Correlation between LUS score and indices of oxygenation and prediction of surfactant administration.RESULTS Among the 130 neonates in this study, the LUS score was significantly correlated with all indices of oxygenation, independent from gestational age (GA)

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Use of Neonatal Chest Ultrasound to Predict Noninvasive Ventilation Failure

Cited by 135 publications

References 31 publications

Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

Respiratory Care of the Neonate

Lung Ultrasonography Score to Evaluate Oxygenation and Surfactant Need in Neonates Treated With Continuous Positive Airway Pressure

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