Lung ultrasonography decreases radiation exposure in newborns with respiratory distress: a retrospective cohort study

Tandircioglu, Umit Ayse; Yiğit, Şule; Oğuz, Berna; Kayki, Gozdem; Çelik, Hasan Tolga; Yurdakök, Murat

doi:10.1007/s00431-021-04296-5

Cited by 11 publications

(12 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…29 Despite the considerable amount of data demonstrating the reliability of LU in the differential diagnosis of neonatal respiratory diseases, [3][4][5][6]12 23% of Italian NICUs use LU as the first-choice imaging test for neonates admitted with respiratory diseases. Yet, a greater reliance on the use of LU would lead to a reduced exposure to ionizing radiation of newborns 30 and faster diagnostic times, 6 in addition to ensuring optimal diagnostic accuracy, even in comparison to CXR. Timeliness of treatment can be particularly important in rapidly evolving critical conditions such as PNX.…”

Section: Discussionmentioning

confidence: 99%

Lung ultrasound in Italian neonatal intensive care units: A national survey

Corsini

Parri

Ficial

et al. 2022

Pediatric Pulmonology

View full text Add to dashboard Cite

Introduction Lung ultrasound (LU) is a noninvasive, bedside imaging technique that is attracting growing interest in the evaluation of neonatal respiratory diseases. We conducted a nationwide survey of LU usage in Italian neonatal intensive care units (NICUs). Methods A structured questionnaire was developed and sent online to 114 Italian NICUs from June to September 2021. Results The response rate was 79%. In the past 4 years (range: 2–6), LU has been adopted in 82% of Italian NICUs. It is the first‐choice diagnostic test in 23% of the centers surveyed. The main LU diagnostic applications reported were: pneumothorax (95%), respiratory distress syndrome (89%), transient tachypnea of the newborn (89%), plural effusion (88%), atelectasis (66%), pneumonia (64%), bronchopulmonary dysplasia (43%), congenital pulmonary airway malformation (41%), and congenital diaphragmatic hernia (34%). Thirty percent of participating centers calculated LU score routinely, but only seven units used it to predict the need for surfactant replacement. Sixty‐six percent of respondents learned the LU technique via a self‐training process, while 34% of them visited an expert in the field for one‐to‐one tuition. Conclusions LU has a widespread use in Italian NICUs. However, the use of LU is extremely heterogeneous among centers. There is an urgent need to ensure standardization of clinical practice guidelines and to design and implement a formalized and accredited training program.

show abstract

Section: Discussionmentioning

confidence: 99%

Lung ultrasound in Italian neonatal intensive care units: A national survey

Corsini

Parri

Ficial

et al. 2022

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…19 However, tools used in the diagnosis and management of BPD, such as serial chest X-ray, CT scan, are poorly correlated with BPD severity and clinical outcomes and are related to high radiation exposure. 20,21 LUS may be a potential radiation-free, portable, and noninvasive modality to confirm the diagnosis of BPD. Moreover, the direction of the radiation beam may cause difficulties in detecting certain lung regions such as posterior, parasternal, or paravertebral lung areas.…”

Section: Discussionmentioning

confidence: 99%

Lung ultrasound scores within the first 3 days of life to predict respiratory outcomes

Aliyev,

Kayki,

Annakkaya Kocyigit

et al. 2023

Pediatric Pulmonology

Self Cite

View full text Add to dashboard Cite

BackroundLung ultrasound (LUS) is a rapid and simple method to evaluate preterm babies with respiratory distress. Lately, LUS has also been reported as an accurate predictor for bronchopulmonary dysplasia (BPD).ObjectivesThe aim of the study was to investigate the relationship between the LUS scores within the first 3 days of life and respiratory outcomes including the need and the duration of invasive mechanical ventilation, and development of BPD.MethodsIt was a retrospective observational study. Preterm infants younger than 32 weeks were included at an academic tertiary Neonatal Intensive Care Unit between 2018 and 2023. LUS was performed within the first 3 days. Each lung was divided into three regions and defined as a score of 0 to 3 points; the total score was obtained by adding the six regional scores. LUS scores were noted in two groups as the highest and lowest scores. Statistical analyses were done to predict respiratory outcomes.ResultsTotal 218 patients were enrolled; 40, 17, and 18 infants had mild, moderate, and severe BPD, respectively. BPD did not develop in 143 patients. Within the first 3 days, the highest and lowest LUS scores significantly predicted moderate‐to‐severe BPD (p < .001) (area under receiver operating characteristic [ROC] curve, 0.684–0.913; area under ROC curve 0.647–0.902; respectively). High LUS scores were also related with the need of mechanical ventilation (p < .001). There was not a significant correlation between the duration of mechanical ventilation and the LUS scores. Regression analysis revealed that the highest LUS scores within the first 3 days of life, sepsis, and the presence of hemodynamically significant patent ductus arteriosus (hsPDA) were significantly associated with the severity of BPD.ConclusionsIn preterm babies, the LUS scores were useful to predict BPD and the need of invasive ventilation in long term. However, it was not related with the length of invasive ventilation.

show abstract

“…Escourrou and De Luca used lung ultrasonography as the first-line imaging technique and chest radiography as the second-line examination in infants with respiratory distress in the NICU and successfully reduced the mean number of chest radiography per infant from 4.9 to 2.6. In addition, the mean radiation dose per infant was reduced from 183 to 68 μGy, and the percentage of infants who underwent chest radiography was reduced by 11% (from 81 to 69.7%) [ 18 , 37 ]. In 2020, the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) issued evidence-based POCUS guidelines to optimise POCUS use in diagnosis and procedural performance in critically ill neonates and children [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 2020, the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) issued evidence-based POCUS guidelines to optimise POCUS use in diagnosis and procedural performance in critically ill neonates and children [ 16 ]. Nowadays, the POCUS technique has been integrated into clinical protocols and suggested as a first-line tool to replace conventional radiography in infants in many NICUs [ 18 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Unnecessary radiation exposure during diagnostic radiography in infants in a neonatal intensive care unit: a retrospective cohort study

Chen

Yeh

et al. 2022

Eur J Pediatr

View full text Add to dashboard Cite

Unnecessary radiation exposure (URE) during radiographic examination is an issue among infants in neonatal intensive care units (NICUs). The causes of URE have not been fully explored. This study investigated the incidence and identified the causes of URE in infants during diagnostic radiography in a NICU. This was a retrospective cohort study. We retrieved and analysed requests and radiographs taken at a tertiary NICU between September and November 2018. URE was defined as the rate of discordance between requests and images taken (DisBRI) and unnecessary radiation exposure in irrelevant regions (UREIR) during radiography. We compared the rates of URE between very low-birth-weight (VLBW, birth weight < 1500 g) infants and non-VLBW infants. A total of 306 radiographs from 88 infants were taken. The means ± standard deviations (SDs) of gestational age and birth weight were 35.7 ± 3.6 weeks and 2471 ± 816 g, respectively. Each infant underwent an average of 3.5 radiographs. The DisBRI rate was 1.3% and was mostly related to poor adherence to requests. The UREIR rates in thoraco-abdominal babygrams were 89.6% for the head, 14.8% for the elbows and 18.4% for the knee and were mainly related to improper positioning of and collimation in infants while performing radiography. The UREIR rates for the head, knee and ankle were higher in VLBW infants than in non-VLBW infants (94.6% vs. 85.6%, 27.0% vs. 11.5% and 5.4% vs. 0.7%, respectively, p < 0.05).Conclusions: URE during diagnostic radiography is common in sick infants and is mainly related to improper positioning and collimation during examinations. Adherence to protocols when performing radiographic examination or using ultrasonography may be a solution to reduce URE in infants in NICUs. What is Known:• The risk of unnecessary radiation exposure (URE) during radiography has been a common and important issue in sick infants in neonatal intensive care units (NICUs).• The new point-of-care ultrasound (POCUS) technique decreases the need for chest films and prevents radiation exposure in neonates. What is New:• In the NICU, URE is still a common issue in critically ill infants during radiographic examinations. The causes of URE during diagnostic radiography are mainly due to improper positioning and collimation during examinations.• The incidence of URE in irrelevant regions is higher in very low-birth-weight (VLBW) infants than in non-VLBW infants.

show abstract

Lung ultrasonography decreases radiation exposure in newborns with respiratory distress: a retrospective cohort study

Cited by 11 publications

References 29 publications

Lung ultrasound in Italian neonatal intensive care units: A national survey

Lung ultrasound in Italian neonatal intensive care units: A national survey

Lung ultrasound scores within the first 3 days of life to predict respiratory outcomes

Unnecessary radiation exposure during diagnostic radiography in infants in a neonatal intensive care unit: a retrospective cohort study

Contact Info

Product

Resources

About