Neonatal lung ultrasound exam guidelines

Kurepa, Dalibor; Zaghloul, Nahla; Watkins, Laura; Liu, J

doi:10.1038/jp.2017.140

Cited by 123 publications

(171 citation statements)

References 46 publications

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“…In the 12 regions protocol, anterior, lateral, and posterior areas were included, but in each region, only the intercostal space with the worst ultrasound pattern was calculated . In neonates, linear transducers have been commonly used, and the posterior area is mostly considered . For this reason, the protocol used in this experiment also included the posterior chest.…”

Section: Discussionmentioning

confidence: 99%

“…EVLW manifests as B‐lines that can be recognized as vertical, hyperechoic lines similar to a laser; these lines extend from the pleural line to the bottom of the screen with no signs of fading and will move synchronously with lung sliding . Specifically, the acoustic interface that generates B‐lines was originally suggested as edema‐thickened subpleural interlobular septa.…”

Section: Methodsmentioning

confidence: 99%

“…Lung ultrasound (LUS) has become a bedside technology for critical care due to its availability for implementation and immediate interpretation by clinicians. Standardized LUS signs have been established for both adults and neonates . Extravascular lung water (EVLW) refers to the water content in lungs outside of the pulmonary blood vessels, typically, fluid accumulates in the interstitial and alveolar spaces, while the accumulation of EVLW clinically manifests as pulmonary edema …”

Section: Introductionmentioning

confidence: 99%

“…In contrast, transthoracic LUS, a technique used on the basis of B‐line visualization, is highly sensitive and specific to the diagnosis of EVLW . LUS scoring systems have been developed to meet the need for standardization and have been shown to correlate with various metrics in adults and neonates .…”

Section: Introductionmentioning

confidence: 99%

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Using lung ultrasound to quantitatively evaluate pulmonary water content

Zong

Guo

Liu

et al. 2020

Pediatric Pulmonology

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Background Increases in extravascular lung water (EVLW) can lead to respiratory failure. This study aimed to investigate whether the B‐line score (BLS) was correlated with the EVLW content determined by the lung wet/dry ratio in a rabbit model. Methods A total of 45 New Zealand rabbits were randomly assigned to nine groups. Among the animals, models of various lung water content levels were induced by the infusion of different volumes of warm sterile normal saline (NS) via the endotracheal tube. The arterial blood gas, spontaneous respiratory rate, and PaO2/FiO2 ratio were detected before and after infusion. In addition, the B‐lines were determined before and immediately after infusion in each group. Finally, both lungs were resected to determine the wet/dry ratio. In addition, all lung specimens were analyzed histologically, and EVLW was quantified using the BLS based on the number and confluence of B‐lines in the intercostal space. Results The BLS increased with increasing infusion volume. The BLS was statistically correlated with the wet/dry ratio (r2= .946) and with the PaO2/FiO2 ratio (r2= .916). Furthermore, a repeatability study was performed for the lung ultrasound (LUS) technology (Bland‐Altman plots), and the results suggest that LUS had favorable intraobserver and interobserver reproducibility. Conclusions This study is the first to suggest that the BLS can serve as a sensitive, quantitative, noninvasive, and real‐time indicator of EVLW in a rabbit model of lung water accumulation. Notably, the BLS displayed an obvious correlation with the experimental gravimetry results and could also be used to predict the pulmonary oxygenation status.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Using lung ultrasound to quantitatively evaluate pulmonary water content

Zong

Guo

Liu

et al. 2020

Pediatric Pulmonology

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“…1d) to describe the sharp limit between these 2 areas of different echogenicity. The diagnostic accuracy of the DLP for TTN varies in studies published to date (sensitivity range 100–45.6% and specificity range 100–94.6%) [4, 5]. Moreover, TTN presentation at ultrasound is also variable, ranging from a “white lung” image to a benign pattern with a prevalence of A-lines [6, 7].…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Raimondi

Yousef

Fanjul³

et al. 2019

Neonatology

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Background and Aim: Discordant results that demand clarification have been published on diagnostic lung ultrasound (LUS) signs of transient tachypnea of the neonate (TTN) in previous cross-sectional, single-center studies. This work was conducted to correlate clinical and imaging data in a longitudinal and multicenter fashion. Methods: Neonates with a gestational age of 34–40 weeks and presenting with TTN underwent a first LUS scan at 60–180 min of life. LUS scans were repeated every 6–12 h if signs of respiratory distress persisted. Images were qualitatively described and a LUS aeration score was calculated. Clinical data were collected during respiratory distress. Results: We enrolled 65 TTN patients. Thirty-one (47.6%) had a sharp echogenicity increase in the lower lung fields (the “double lung point” or DLP sign). On admission, there was no significant difference between patients with and without DLP in Silverman scores (4 ± 1.5 vs. 4 ± 2.1; p = 0.9) or LUS scores (7.6 ± 2.6 vs. 5.6 ± 3.8; p = 0.12); PaO₂/FiO₂ (249 ± 93 vs. 252 ± 125; p = 0.91). All initial LUS scans (performed at the onset of distress) and 99.5% of all scans showed a regular pleural line with no consolidation, with only 1 neonate showing consolidation in the follow-up scans. The Silverman and LUS scores were significantly correlated (rho = 0.27; p = 0.02). Conclusion: A regular pleural line with no consolidation is a consistent finding in TTN. The presence of a DLP is not essential for the LUS diagnosis of TTN. A semi-quantitative LUS score correlates well with the clinical course and could be useful in monitoring changes in lung aeration during TTN.

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Lung ultrasound score in the decision of patent ductus arteriosus closure in neonates

Ozdemir,

Tepe,

Ozlu

et al. 2024

J of Clinical Ultrasound

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PurposeWe aimed to investigate the role of lung ultrasound (LUS) score in the closure of hemodynamically insignificant patent ductus arteriosus (PDA) and the clinical findings of the patients before and after closure.MethodsThe study groups (107 preterm neonates under 34 gestational weeks) were classified as hemodynamically significant PDA (group 1), hemodynamically insignificant PDA with closure therapy (group 2), hemodynamically insignificant PDA without closure therapy (group 3), and no PDA group (group 4) based on the echocardiography. 6‐ and 10‐region LUS scores were compared for each group.ResultsThere was a significant difference between groups 1 and 3 on first, third, and seventh days. In contrast, groups 1 and 2 had similar LUS scores on the first, third, and seventh days. There was a negative correlation between LUS scores on the first and third days and gestational age, birth weight, the first‐ and fifth‐minute APGAR scores, and there was a positive correlation between aortic root to left atrium ratio, and PDA diameter/weight ratio.ConclusionWe observed that LUS scores in patients with hemodynamically insignificant PDA treated with closure therapy were similar to in patients with hemodynamically significant PDA. Thus, LUS score can have role in PDA closure in preterm neonates. However, more comprehensive studies are needed.

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Neonatal lung ultrasound exam guidelines

Cited by 123 publications

References 46 publications

Using lung ultrasound to quantitatively evaluate pulmonary water content

Using lung ultrasound to quantitatively evaluate pulmonary water content

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Lung ultrasound score in the decision of patent ductus arteriosus closure in neonates

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