Specification and guideline for technical aspects and scanning parameter settings of neonatal lung ultrasound examination

Abstract

Lung ultrasound (LUS) is now widely used in the diagnosis and monitor of neonatal lung diseases.Nevertheless, in the published literatures,the LUS images may display a significant variation in technical execution,while scanning parameters may influence diagnostic accuracy.The inter-and intra-observer reliabilities of ultrasound exam have been extensively studied in general and in LUS.As expected,the reliability declines in the hands of novices when they perform the point-of-care ultrasound (POC US).Consequently,having appropriate guidelines regarding to technical aspects of neonatal LUS exam is very important especially because diagnosis is mainly based on interpretation of artifacts produced by the pleural line and the lungs.The present work aimed to create an instrument operation specification and parameter setting guidelines for neonatal LUS.Technical aspects and scanning parameter settings that allow for standardization in obtaining LUS images include (1)select a high-end equipment with high-frequency linear array transducer (12-14 MHz).(2)Choose preset suitable for lung examination or small organs.(3)Keep the probe perpendicular to the ribs or parallel to the intercostal space.(4)Set the scanning depth at 4-5 cm.(5)Set 1-2 focal zones and adjust them close to the pleural line.(6)Use fundamental ARTICLE HISTORY

Lung Ultrasound for the Diagnosis and Management of Neonatal Respiratory Distress Syndrome: A Minireview

“…Lung ultrasound plays an important role in the diagnosis and management of RDS, but non-standardization of scanning methods, and incorrect instrument operation and parameter adjustment will seriously affect the accuracy of the examination; thus, it is quite important to accept training in LUS to improve interobserver consistency in diagnostic accuracy, reliability, and patient outcomes ( 37 ).…”

The Mechanisms Underlying Vertical Artifacts in Lung Ultrasound and Their Proper Utilization for the Evaluation of Cardiogenic Pulmonary Edema

“…Many published studies that used B-lines as a metric do not provide information on the machine settings [9]. In this chapter, we explain several machine settings that have a large impact on the configuration of vertical artifacts based on our basic research [8] and clinical experience with some references [21] 3.1. Spatial Compound Imaging Spatial compound imaging is now available on most ultrasound machines.…”

“…If one of the presets for these applications is accidentally selected for the evaluation of B-lines, they may be erroneously counted. To avoid misinterpretation, spatial compound imaging should be set to “off” [ 8 , 19 , 21 ], or the preset for the lung ultrasound should be selected in advance. In phased array transducers, spatial compound imaging is not mounted; thus, B-lines can be properly evaluated without caution when utilized in addition to echocardiography [ 9 ].…”

“…However, at present, the confluent B-lines are not precisely defined in the consensus definitions [ 25 ]. For consensus, it is recommended that focal point be set at or near the level of the pleural line to ensure “confluence” and accurate quantification or semi-quantification of B-lines [ 8 , 9 , 19 , 21 ]. In some portable or hand-held ultrasound machines, the focal point is fixed to a certain level by default and cannot be moved by the user.…”

Lung Ultrasound in the Neonatal Intensive Care Unit: Does It Impact Clinical Care?

“…The evidence for evaluating pulmonary edema and detecting anesthesia-induced atelectasis was weaker (level C). Several algorithms have been proposed for neonatal LUS, including the assessment of life threatening emergencies [ 2 , 22 ], neonatal respiratory pathologies algorithm [ 8 ], and the neonatal LUS protocol [ 23 , 24 ]. The SAFE-R protocol was designed for use in the decompensating neonate and includes the evaluation of cardiac tamponade, pneumothorax, pleural effusion, and myocardial function [ 22 ].…”