The Diagnosis of Neonatal Pulmonary Atelectasis Using Lung Ultrasonography

Liu, Jing; Chen, Shui-Wen; Liu, Fang; Li, Qiuping; Kong, Xiangdong; Feng, Zhichun

doi:10.1378/chest.14-1306

Cited by 84 publications

(71 citation statements)

References 15 publications

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“…An irregular pleural-line image with significant “subpleural” consolidations is a typical sign of RDS, pneumonia, and meconium aspiration syndrome [20-23]. Consistent with previous studies, our TTN neonates showed a regular ultrasound appearance of the pleura.…”

Section: Discussionsupporting

confidence: 90%

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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Section: Discussionsupporting

confidence: 90%

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Raimondi

Yousef

Fanjul³

et al. 2019

Neonatology

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“…[9,12,18,19] From our results above, LUS more easily found the hidden lesions of lung than CR. The possible causes of traditional CR difficulty in finding these lesions were as follows: the scope of lesions was too small; the radiation dose of CR did not meet the requirements; the effect of lesion location and the transillumination angle or direction of CR such as for lesions in the deep lung field were not completely displayed on regular CR.…”

Section: Discussionmentioning

confidence: 79%

“…However, the use of CR or CT especially for neonates is limited because of transportation and inevitable radiation. Increasing the awareness and advancement of lung ultrasonography (LUS) has led to the diagnosis of many lung diseases by LUS in both children and adults, [2–8] and the diagnosis of some lung diseases in new infants, [9–11] but LUS is still not commonly used for diagnosing and monitoring neonatal pulmonary diseases. Therefore, the aim of this study was to find the features of LUS in lung diseases in neonatal intensive care unit (NICU) patients and to promote its application in newborn respiratory diseases.…”

Section: Introductionmentioning

confidence: 99%

Routine application of lung ultrasonography in the neonatal intensive care unit

Chen

Liu

et al. 2017

Medicine

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The aim of this study was to study the features of lung ultrasonography (LUS) in lung disease and to evaluate the usefulness of LUS in the neonatal intensive care unit (NICU).All of 3405 neonates included in this study underwent an LUS examination. Diagnoses were based on medical history, clinical manifestation, laboratory examination, and signs on chest radiography (CR) and/or computed tomography (CT). A single expert physician performed all LUS examinations.There were 2658 cases (78.9%) with lung disease and 747 cases (21.9%) without lung disease. The main signs of neonates with lung disease on LUS were as follows: absence of A-lines, pleural-line abnormalities, interstitial syndrome, lung consolidation, air bronchograms, pulmonary edema, and lung pulse. These abnormal signs were reduced or eliminated on LUS as patient conditions improved. There were 81 cases that could not be diagnosed as lung disease by CR but were discovered as pneumonia, respiratory distress syndrome (RDS), or transient tachypnea of newborn (TTN) on LUS. Likewise, 23 cases misdiagnosed as RDS by CR were diagnosed as TTN on LUS. Among 212 cases of long-term oxygen dependence (LTOD) that failed to yield signs of pulmonary edema and lung consolidation on CR, 103 cases showed abnormal signs on LUS. Among 747 cases without lung disease, B-lines of 713 neonates (95.4%) could be found within 3 days after birth, and 256 neonates (34.3%) could be observed from 3 days to 1 week after birth. B-lines of 19 cases could be detected from 1 to 2 weeks after birth. The longest time at which B-lines could still be observed was 19 days after birth.LUS has clinical value for the diagnosis of lung disease and the discrimination of causes of LTOP in premature infants, particularly for the diagnosis and identification of RDS and TTN. Moreover, LUS has additional advantages, including its lack of radiation exposure and its ability to noninvasively monitor treatment progress. Therefore, LUS should be routinely used in the NICU.

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“…LUS is a useful and promising tool in the diagnosis and management of MAS [4]. LUS is an accurate and reliable method for diagnosing neonatal pulmonary atelectasis (NPA) [15]. LUS is found to be superior to CXR in the detection of complications of RDS, particularly consolidation, atelectasis, and microabscesses [16].…”

Section: Discussionmentioning

confidence: 99%

“…In cases of neonatal pulmonary atelectasis, LUS was more sensitive in detecting occult lesions than CXR [15]. …”

Section: Discussionmentioning

confidence: 99%

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

Ibrahim

Omran

Ibrahim

et al. 2016

Case Reports in Pediatrics

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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.

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The Diagnosis of Neonatal Pulmonary Atelectasis Using Lung Ultrasonography

Cited by 84 publications

References 15 publications

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Routine application of lung ultrasonography in the neonatal intensive care unit

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

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