Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Liu, Jing; Copetti, Roberto; Sorantin, Erich; Lovrenski, Jovan; Rodríguez-Fanjul, Javier; Kurepa, Dalibor; Feng, Xing; Cattaross, Luigi; Zhang, Huayan; Hwang, Misun; Yeh, Tsu F.; Lipener, Yisrael; Lodha, Abhay; Wang, Jia Qin; Cao, Hai Ying; Hu, Cai; Lyu, Guo Rong; Qiu, Xin Ru; Li, Jia; Wang, Xiao Man; Ren, Xiao Ling; Guo, Jiu Ye; Gao, Yue Qiao; Li, Jian Jun; Liu, Ying; Fu, Wei; Wang, Yan; Lu, Zu Lin; Wang, Hua Wei; Shang, Li Li

doi:10.3791/58990

Cited by 106 publications

(200 citation statements)

References 44 publications

(59 reference statements)

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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%

“…Standardized LUS signs have been established for both adults and neonates. [1][2][3][4][5] 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. 6 Pulmonary edema is one of the most critical pathological changes in various pulmonary diseases.…”

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%

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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The application value of lung ultrasound scoring in assessing disease severity: Evaluation of small‐scale outbreaks of COVID‐19

Han,

Ke,

Xiao

et al. 2023

J of Clinical Ultrasound

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PurposeThis study explored the use of transthoracic lung ultrasound for evaluating COVID‐19 patients, compared it with computed tomography (CT), and examined its effectiveness using 8 and 12 lung regions.MethodsA total of 100 patients with COVID‐19 and 40 healthy volunteers were assessed using 12 regions (bilateral upper/lower regions of the anterior/lateral/posterior chest) and simplified 8 zones (bilateral upper/lower regions of the anterior/lateral chest) transthoracic lung ultrasound. The relationships between ultrasound, CT, and clinical indicators were analyzed to evaluate the diagnostic value of ultrasound scores in COVID‐19.ResultsIncreased disease severity correlated with increased 8‐ and 12‐zone ultrasound and CT scores (all p < 0.05). The modified 8‐zone method strongly correlated with the 12‐zone method (Pearson's r = 0.908, p < 0.05). The 8‐ and 12‐zone methods correlated with CT scoring (correlation = 0.568 and 0.635, respectively; p < 0.05). The intragroup correlation coefficients of the 8‐zone, 12‐zone, and CT scoring methods were highly consistent (intragroup correlation coefficient = 0.718, p < 0.01). The 8‐zone ultrasound score correlated negatively with oxygen saturation (rs = 0.306, p < 0.05) and Ca (rs = 0.224, p < 0.05) and positively with IL‐6 (rs = 0.0.335, p < 0.05), erythrocyte sedimentation rate (rs = 0.327, p < 0.05), alanine aminotransferase (rs = 0.230, p < 0.05), and aspartate aminotransferase (rs = 0.251, p < 0.05). The 12‐zone scoring method correlated negatively with oxygen saturation (rs = 0.338, p < 0.05) and Ca (rs = 0.245, p < 0.05) and positively with IL‐6 (rs = 0.354, p < 0.05) and erythrocyte sedimentation rate (rs = 0.495, p < 0.05).ConclusionLung ultrasound scores represent the clinical severity and have high clinical value for diagnosing COVID‐19 pneumonia. The 8‐zone scoring method can improve examination efficiency and reduce secondary injuries caused by patient movement.

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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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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Cited by 106 publications

References 44 publications

Using lung ultrasound to quantitatively evaluate pulmonary water content

Using lung ultrasound to quantitatively evaluate pulmonary water content

The application value of lung ultrasound scoring in assessing disease severity: Evaluation of small‐scale outbreaks of COVID‐19

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

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