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, Haiying; Hu, Caibao; Lyu, Guorong; Qiu, Xin-Ru; Jia, Liqun; Ren, Xiang; Guo, Jiu-Ye; Gao, Yue-Qiao; Li, Jianjun; Liu, Ying; Fu, Wei; Wang, Yan; Lu, Zu-Lin; Wang, Huawei; Shang, Li-Li

doi:10.3791/58990-v

Cited by 17 publications

(41 citation statements)

References 36 publications

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“…In M-mode, the lack of pleural sliding in pneumothorax does not show the typical seashore sign but rather the pathognomic barcode or stratosphere sign ( Fig. 11 ) 6 34 .…”

Section: Pneumothoraxmentioning

confidence: 99%

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Pulmonary Sonography – Neonatal Diagnosis Part 2

Schwarz

2023

Ultraschall Med

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A healthy, air-filled lung can only be visualized by its artifacts, and pathologies of the lung are revealed by changes in these artifacts. Because ultrasound artifacts are predominantly used in pulmonary sonography to assess pathologic processes, the variability of sonographically imageable phenomena is limited. For this reason, different pulmonary diseases may present very similarly in ultrasound. Therefore, a correct interpretation of the findings is only possible in the clinical context, taking into account the age-dependent differential diagnoses.The particular relevance of lung ultrasound in the treatment of neonatal patients results from a close correlation between the extent of sonographically-depictable pathologies and parameters of respiratory insufficiency. This suggests a direct correlation between ultrasound findings and the severity of lung injury. Lung ultrasound thus represents a unique, ubiquitously available, bedside, serial method for monitoring the pulmonary status.

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“…In M-mode, the lack of pleural sliding in pneumothorax does not show the typical seashore sign but rather the pathognomic barcode or stratosphere sign ( Fig. 11 ) 6 34 .…”

Section: Pneumothoraxmentioning

confidence: 99%

“…Thus, PTX is sonographically characterized by lack of pleural sliding, lack of visualization of B-lines and consolidations, visualization of the so-called lung point where the visceral pleura and parietal pleura separate, and lack of visualization of the pulmonary pulse in M-mode (▶ Fig. 10, 11 ▶ Video 1, 6-8, ▶ Table 1) [6,34].…”

Section: Op-videomentioning

confidence: 99%

Pulmonary Sonography – Neonatal Diagnosis Part 2

Schwarz

2023

Ultraschall Med

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“…The system ignores the influence of the transducer frequency on LUS findings. It is well known that the transducer frequency substantially affects the accuracy of the results of LUS examinations, and a high‐frequency transducer is required for neonatal LUS examinations . When the frequency of the transducer is different, the score is different for same area.…”

mentioning

confidence: 99%

“…Consequently, the scoring criteria are not helpful to distinguish the difference between coalescent B-lines and dense B-lines. However, the latter reflect more severe lung edema, 8 but the LUS score should be the same according to the criteria (Figure 1). 5.…”

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confidence: 99%

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The Lung Ultrasound Score Cannot Accurately Evaluate the Severity of Neonatal Lung Disease

Liu

2019

J of Ultrasound Medicine

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F or nearly a decade, lung ultrasound (LUS) has been extensively used in the diagnosis and differential diagnosis of neonatal lung diseases because of its increased accuracy and effectiveness compared with traditional chest radiography, and LUS has replaced radiography in the diagnosis of neonatal lung diseases in some neonatal intensive care units. [1][2][3][4] However, during the development of LUS, it was expected that LUS could quantitatively evaluate the severity of lung diseases, with a so-called LUS scoring system. 5-7 On the basis of my accumulated experience with more than 10 years of research in this field, I found that the LUS score not only cannot be used to accurately assess the severity of neonatal lung disease but also may result in substantial discrepancies.The LUS score has the following major defects and shortcomings:1. A score of 1 is assigned for pulmonary interstitial syndrome according to the presence of "multiple isolated B-lines". However, the term "multiple B-lines" is not clearly defined in the scoring system. For instance, the LUS score would be 1 according to the system, regardless of the presence of 3 or 4 B-lines or more than 10 B-lines. This scoring criterion is obviously inappropriate because the number of B-lines is associated with the severity of edema.2. A score of 1 is assigned for focal lung edema, and a score of 2 is assigned for alveolar edema. For focal lung edema, coalescent B-lines should occupy less than 50% of the intercostal space in the whole lung field. However, for alveolar edema, coalescent B-lines should occupy 100% of the intercostal space in the whole lung field. The question is how the edema should be scored when coalescent B-lines occupy between 50% and 100% of the intercostal space in the field, which is a very common condition in clinical practice. 3. The system ignores the influence of the distribution zones of coalescent B-lines. Lung US commonly displays different patterns of coalescent B-lines in different lung zones. Coalescent B-lines are present in some intercostal spaces, whereas other spaces may be normal or abnormal, reflecting different degrees of

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

Cited by 17 publications

References 36 publications

Pulmonary Sonography – Neonatal Diagnosis Part 2

Pulmonary Sonography – Neonatal Diagnosis Part 2

The Lung Ultrasound Score Cannot Accurately Evaluate the Severity of Neonatal Lung Disease

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

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