Thoracic shape changes in newborns due to their position

Gelidi, Serena de; Bardill, Andy; Seifnaraghi, Nima; Wu, Yu; Demosthenous, Andreas; Rahtu, Marika; Kallio, Merja; Bayford, Richard

doi:10.1038/s41598-021-83869-8

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Similarly to that observed by previous authors, 42,43 in our findings, both groups of infants showed a preponderant increase in latero‐lateral thoracic diameter over the antero‐posterior thoracic diameter from perinatal period to follow‐up. This finding was particularly evident in PE infants in whom the anteroposterior thoracic diameter showed a significantly reduced increase than controls from perinatal period to follow‐up, contributing to maintain an extrinsic cardiac compression.…”

Section: Discussionsupporting

confidence: 92%

Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

Sonaglioni

Nicolosi²,

Braga

et al. 2021

J of Clinical Ultrasound

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Purpose To investigate the possible influence of chest wall conformation on myocardial strain parameters in a consecutive population of infants with pectus excavatum (PE), noninvasively assessed by modified Haller index (MHI). Methods Sixteen consecutive PE infants (MHI >2.5) and 44 infants with normal chest shape (MHI ≤2.5) entered in this prospective case–control study. All infants underwent evaluation by neonatologist, transthoracic echocardiography implemented with two‐dimensional speckle tracking echocardiography (2D‐STE) analysis of both ventricles and MHI assessment (ratio of chest transverse diameter over the distance between sternum and spine), at two time points: within 3 days and at about 40 days of life. Results At 2.1 ± 1 days of life, compared to controls (MHI = 2.01 ± 0.2), PE infants (MHI = 2.76 ± 0.2) were diagnosed with significantly smaller cardiac chambers dimensions. Biventricular contractile function and hemodynamics were similar in both groups of infants. Left ventricular (LV) global longitudinal strain (GLS) (−16.0 ± 2.8 vs. −21.7 ± 2.2%), LV‐global circumferential strain (GCS) (−16.3 ± 2.7 vs. −24.0 ± 5.2%), LV‐global radial strain (GRS) (24.2 ± 3.0 vs. 31.5 ± 6.3%), and right ventricular free wall longitudinal strain (RVFWLS) (−16.0 ± 3.2 vs. −22.3 ± 4.4%) were significantly reduced in PE infants versus controls (all p < 0.001). A strong inverse correlation between MHI and the following parameters: LV‐GLS (r = −0.92), LV‐GCS (r = −0.88), LV‐GRS (r = −0.87), and RVFWLS (r = −0.88), was demonstrated in PE infants, but not in controls, in perinatal period (all p < 0.001). Analogous results were obtained at 36.8 ± 5.2 days after birth. Conclusions Abnormal chest anatomy progressively impairs myocardial strain parameters in PE infants. This impairment might reflect intraventricular dyssynchrony due to compressive phenomena rather than intrinsic myocardial dysfunction.

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Section: Discussionsupporting

confidence: 92%

Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

Sonaglioni

Nicolosi²,

Braga

et al. 2021

J of Clinical Ultrasound

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“…In a child with lower airway obstruction and increased respiratory effort, the peaks of pleural retraction can be appreciated both qualitatively and quantitatively. The first rib space above the diaphragm sees maximum negative pressure created by both the intercostal muscles and the diaphragm creating the ‘bucket‐handle’ motion of the ribs as the diaphragm contracts, 9 particularly in younger children with a pyramidal‐shaped chest 10,11 . As the pleural line slope is a sonographic representation of intercostal retractions, this area of the chest wall is the most likely to produce readily identifiable peaks and valleys on m‐mode tracing.…”

Section: Discussionmentioning

confidence: 99%

Pleural line slope in point of care ultrasound assessment of paediatric wheeze may reflect respiratory effort

Scheier,

Shoseyov

2023

Acta Paediatrica

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AimAsthma scoring systems rely on physical examination findings. Point of care ultrasound may provide an objective means to document improvement in the work of breathing in paediatric lower airway obstruction.MethodsThirty children with wheeze on physical examination (cases) and 15 children presenting with abdominal pain (controls) were studied. Using point‐of‐care ultrasound, m‐mode tracing of lung was recorded above the right hemidiaphragm at the midclavicular line. Pleural line slope and excursion were measured before and after treatment.ResultsTwenty patients had a final slope measurement under 20°, and only three were admitted—one for hypoxia that resolved prior to ascending to the ward and another for poor compliance. Average decrease in pleural line slope after treatment was 43% and average decrease in pleural line excursion was 32%. Of the 10 children admitted, 8 had measurements over 25°. The correlation coefficient between pleural slope and pleural excursion was 0.67. All controls had a horizontal m‐mode tracing at the pleural line.ConclusionOscillation of the m‐mode line at the pleura is seen in children with lower airway obstruction and is absent in controls. There appears to be a correlation between beta‐agonist therapy and decreased pleural line slope and excursion.

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“…Ideally the image reconstruction algorithm should use realistic patient specific models. This type of model preparation is obtainable using a combination of sensors like gravitation sensors [ 3 ] when measured superficially or via magnetic resonance imaging (MRI) or computed tomography (CT) scans. The required equipment to conduct the external detection is not often available and the latter cases become rare within the considered age group amid the vulnerability of infants to high radiation dosage in CT-scans [ 4 ] or necessity of sedation during MRI.…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional chest circumference and shape development in infants

et al. 2022

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Objective This study investigates the development of the thoracic cross-section at the nipple line level during the early stages of life. Unlike the descriptive awareness regarding chest development course, there exist no quantitative references concerning shape, circumference and possible dependencies to age, gender or body weight. The proposed mathematical relations are expected to help create guidelines for more realistic modelling and potential detection of abnormalities. One potential application is lung electrical impedance tomography (EIT) monitoring where accurate chest models are crucial in both extracting reliable parameters for regional ventilation function and design of EIT belts. Despite their importance, such reference data is not readily available for the younger age range due to insufficient data amid the regulations of neonatal imaging. Results Chest circumference shows the highest correlation to body weight following the relation $$f\left(x\right)= 18.3735 \ \mathrm{ln}\left(0.0012x+2.1010\right)$$ f x = 18.3735 ln 0.0012 x + 2.1010 where x is the body weight in grams and f(x) is the chest circumference in cm at the nipple line level. No statistically significant difference in chest circumference between genders was detected. However, the shape indicated signs of both age and gender dependencies with on average boys developing a more rectangular shape than girls from the age of 1 years and 9 months.

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Thoracic shape changes in newborns due to their position

Cited by 5 publications

References 8 publications

Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

Pleural line slope in point of care ultrasound assessment of paediatric wheeze may reflect respiratory effort

Cross-sectional chest circumference and shape development in infants

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