Lung Ultrasound for Diagnosing Pneumothorax in the Critically Ill Neonate

Raimondi, Francesco; Fanjul, Javier Rodríguez; Aversa, Salvatore; Chirico, G; Yousef, Nadya; Luca, Danièle De; Corsini, Iuri; Dani, Carlo; Grappone, Lidia; Orfeo, Luigi; Migliaro, Fiorella; Vallone, Gianfranco; Capasso, Letizia; Sodano, Angela; Veropalumbo, C.; Giannattasio, Antonietta

doi:10.1016/j.jpeds.2016.04.018

Cited by 171 publications

(143 citation statements)

References 22 publications

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“…With regards to the diagnosis of PNX, we found that LUS is more accurate than previously reported [24], considering that our two false-negative diagnoses of PNX were made in neonates with small and not clinically relevant PNX. Thus, our data confirm that LUS is excellent for the detection of critical and clinically relevant PNX, as recently reported by Raimondi et al [19]. With the exception of a case report [21], we report for the first time data on the diagnosis of CDH by LUS, detailing that LUS may play a role in the postnatal diagnosis of this disease.…”

Section: Discussionsupporting

confidence: 91%

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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: 91%

“…The LUS diagnostic criteria for various neonatal respiratory diseases are detailed in Table 1 [3, 8, 16, 19-21]. In case the diagnostic criteria for each disease were fulfilled only partially, we assigned the diagnosis that satisfied the largest number of criteria.…”

Section: Methodsmentioning

confidence: 99%

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

et al. 2018

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“…In a prospective study conducted with 42 neonates, pneumothorax was detected in 62% of the patients. While clinical evaluation had 84% sensitivity and 56% specificity, LUS had 100% for both parameters, similar to adult studies …”

Section: Abnormal Findings and Clinical Syndromessupporting

confidence: 60%

Point‐of‐care lung ultrasound in paediatric critical and emergency care

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Gaspar

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et al. 2018

J Paediatrics Child Health

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Ultrasound techniques have been developed since the past century and are becoming more useful in different areas of medical knowledge. More recently, lung ultrasound gained importance throughout artefacts analysis to help clinical evaluation at bedside and became subject of interest in the paediatric intensive care and emergency department settings for both procedural and diagnostic purposes. The normal pattern of lung ultrasound is defined by the presence of lung sliding associated with A-lines whereas B-lines may be representative of pathologic findings. This review focuses on some of the most common pulmonary conditions, their respective sonographic features and clinical implications in the emergency department and paediatric intensive care unit.

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“…Pneumothorax: ultrasound has been shown to be highly accurate to diagnose pneumothoraces in the neonatal ICU in 2 prospective observational studies [198, 199]. Ultrasound has also been reported to assist with needle aspiration of a spontaneous pneumothorax in a preterm infant [200] and in a series of pediatric ED patients by tracking the sonographic “lung point” [106, 201].…”

Section: Diagnostic Applications Of Ultrasoundmentioning

confidence: 99%

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

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The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

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Lung Ultrasound for Diagnosing Pneumothorax in the Critically Ill Neonate

Cited by 171 publications

References 22 publications

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

Point‐of‐care lung ultrasound in paediatric critical and emergency care

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

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