Lung Ultrasound in Early Diagnosis of Neonatal Ventilator Associated Pneumonia before Any Radiographic or Laboratory Changes

Abstract

Neonatal pneumonia is reported to be the primary cause of neonatal respiratory failure and one of the common causes of neonatal hospitalization and death in developing countries. Chest X-ray was considered the gold standard for diagnosis of neonatal pneumonia. Lung ultrasonography has been described as a valuable noninvasive tool for the diagnosis of many neonatal pulmonary diseases. We report a case of ventilation associated neonatal pneumonia with very early diagnosis using lung ultrasound before any significant radiographic changes in chest X-ray or laboratory findings suggestive of infection.

Point of Care Lung Ultrasound in Neonatology

“…Sensitivities of both the absence of lung sliding and that of B-lines for pneumothorax were 100%, and the specificity of the lung point for pneumothorax was 100% in a neonatal pneumothorax study. 32 In an adult study, 33 the absence of lung sliding and the presence of A-lines had a sensitivity and specificity of 95% and 94% of diagnosing occult pneumothorax respectively. In another adult study, 34 the absence of lung sliding has a negative predictive value of 100%.…”

“…Interestingly, after sudden decompensation, an LUS could be performed in an average time of 5.3 ± 5.6 minutes versus 19 ± 11.7 minutes required for a chest radiography, potentially preventing delay in care implementation. 32…”