Use of Neonatal Lung Ultrasound for the Early Detection of Pneumothorax

Deng, Bi-Ying; Li, Ning; Wu, Wei; He, Xiaoguang; Liu, Jinfeng; Huang, Tian-li; Li, Yuchan; Jiang, Shuanglan

doi:10.1055/s-0039-1688999

Cited by 23 publications

(28 citation statements)

References 23 publications

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“…LUS for the diagnosis of neonatal PTX is a manageable and timely diagnostic modality 17,19,20,21,22,23,30,35,36,37,38 . Recent animal studies found that the LUS diagnosis of PTX is very accurate and reliable 39,40 .…”

Section: Discussionmentioning

confidence: 99%

“…In one of these studies LUS and chest X-rays findings of PTX were compared to CT scans as a point of reference and confirmed that LUS is superior to chest X-rays in diagnosis of small PTXs 40 . In newborn infants with PTX, LUS sensitivity and specificity are also higher than that of chest X-rays 17,[19][20][21][22][23]37,38 , and recent meta-analysis further established that the sensitivity of LUS in diagnosing PTX is nearly 50% higher than the chest X-ray sensitivity 41,42 .…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the usefulness of LUS to diagnose PTX has been described in infants 19,20,21,22,23,24 . CT could not be used as the benchmark in neonatal patients, thus LUS was compared with chest X-ray and clinical exam findings.…”

Section: Introductionmentioning

confidence: 92%

“…For these reasons, in many neonatal intensive care units (NICUs), LUS is replacing chest X-rays in diagnosing PTX due to its superior sensitivity and specificity [15][16][17] . Moreover, LUS has been shown to be more accurate than chest X-rays even for small, non-tension PTX 18,19,20,21,22,23,24,25,26,27 . LUS signs of PTX were first studied and described in adult critical patients.…”

Section: Introductionmentioning

confidence: 99%

“…The diagnostic accuracy showed a sensitivity of 100%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 100% 16,17,18,19 . In cases characterized by large PTX, lung point was absent, which consequently decreased the sensitivity of this sign to 75-95% 21,22 . The average time to perform the diagnostic tests in these studies was 5.3 ± 5.6 min for LUS versus 19 ± 11.7 min for a chest X-ray 19 .…”

Section: Introductionmentioning

confidence: 99%

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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Liu¹,

Kurepa

Feletti

et al. 2020

JoVE

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Pneumothorax (PTX) represents accumulation of the air in the pleural space. A large or tension pneumothorax can collapse the lung and cause hemodynamic compromise, a life-threatening disorder. Traditionally, neonatal pneumothorax diagnosis has been based on clinical images, auscultation, transillumination, and chest X-ray findings. This approach may potentially lead to a delay in both diagnosis and treatment. The use of lung US in diagnosis of PTX together with US-guided thoracentesis results in earlier and more precise management. The recommendations presented in this publication are aimed at improving the application of lung US in guiding neonatal PTX diagnosis and management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Liu¹,

Kurepa

Feletti

et al. 2020

JoVE

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Double Doppler Tei index combined with lung ultrasound to evaluate the right ventricular function and lung condition in neonates with pulmonary hypertension

Dai

Lai

Chen

et al. 2022

J of Clinical Ultrasound

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Purpose To explore the applicability of the Tei index combined with lung ultrasound score (LUS) in the evaluation of the lung condition and the right ventricular function of patients with neonatal pulmonary hypertension (PH). Methods Thirty healthy neonates and 75 neonates with PH were included. Two‐dimensional, M‐mode, and double Doppler ultrasound were used to detect RVFAC, TAPSE, TAPSV, and double Doppler Tei index (DD‐Tei index). Intra‐group correlation coefficient (ICC), Bland–Altman, the Spearman rank method, and the ROC (receiver operating characteristic) were used for other objectives within the study. LUS was used to score the lung condition of 75 neonates with PH with or without respiratory distress and 30 normal neonates in the control group, and the differences were compared. Spearman rank correlation was used to analyze the lung score, DD‐Tei index, pulmonary artery pressure, assisted breathing therapy, and the correlation of invasive mechanical ventilation. Results There were statistically significant differences in the decrease of the values of RVFAC, TAPSE, TAPSV, and the increase of the DD‐Tei index among the groups. RVFAC, TAPSE, TAPSV, and DD‐Tei index showed good performance for PH, and the DD‐Tei index had the best diagnostic performance. The increase in pulmonary artery pressure, lung score, and DD‐Tei index in the PH were statistically significant compared with the control group. The DD‐Tei index and lung scores were positively correlated with pulmonary artery pressure, assisted breathing therapy, and invasive mechanical ventilation. Conclusion Dual Doppler ultrasonography combined with pulmonary ultrasound performed well in the assessment of the right ventricular function and lung condition of neonatal with PH.

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Pleural line thickness reference values for preterm and term newborns

Alonso‐Ojembarrena

Ruiz-González

González-Haba-Martínez

et al. 2020

Pediatric Pulmonology

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Background In lung ultrasound (LUS), the pleural line is an artifact whose thickness depends on the underlying lung pathology. To date there are no published studies on normal values of pleural line thickness (PLT) in newborns. Objective The aim of our study is to describe normal PLT values in term newborn (TN) and preterm newborn (PTN). Methods We recruited eupneic TN and PTN, under 34 weeks of gestation, on their first 24 hours of life. Newborns presenting any respiratory distress since birth were excluded. LUS was performed in four areas: upper anterior, lower anterior, lateral and posterior. At each location, we measured PLT and values where compared. Intraobserver and interobserver agreement were assessed using the intraclass correlation coefficient (ICC), and the kappa coefficient. Results We included 23 TN with a median birth weight of 3365 g (interquartile range [IQR] 3100‐3575 g) and a median gestational age of 39 weeks (IQR, 38‐40 weeks). In the PTN group, 23 patients were included with a median birth weight of 1350 g (IQR, 1150‐1590 g) and a median gestational age of 31 weeks (IQR, 30‐32 weeks). Median PLT values were less than 1 mm, and there were no significant differences between groups at any locations, with the exception of the left lower anterior field (0.79 mm [IQR, 0.72‐0.89 mm] vs 0.68 mm [IQR, 0.62‐0.72 mm]). Intraobserver agreement was high: consistency ICC 0.77 (95% confidence interval [CI], 0.32‐0.92) and absolute ICC 0.78 (95% CI, 0.34‐0.93). Interobserver agreement was high for the definition of thin pleural line as less than 1 mm. Conclusions TN and asymptomatic PTN have similar PLT values. Overall, PLT in healthy newborns should be less than 1 mm.

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Use of Neonatal Lung Ultrasound for the Early Detection of Pneumothorax

Cited by 23 publications

References 23 publications

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Double Doppler Tei index combined with lung ultrasound to evaluate the right ventricular function and lung condition in neonates with pulmonary hypertension

Pleural line thickness reference values for preterm and term newborns

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