Lowering of the Neonatal Lung Ultrasonography Score After NCPAP Positioning in Neonates over 32 Weeks of Gestational Age with Neonatal Respiratory Distress

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2022 Aug 26

PMID 36010259

Authors

Alessandro Perri

Simona Fattore

Vito DAndrea

Annamaria Sbordone

Maria Letizia Patti

Stefano Nobile

Chiara Tirone

Lucia Giordano

Milena Tana

Francesca Priolo

Francesca Serrao

Riccardo Riccardi

Giorgia Prontera

Giovanni Vento

Affiliations

Soon will be listed here.

Abstract

Respiratory distress (RD) is one of the most common causes of admission to the neonatal intensive care unit. Correct diagnosis and timely intervention are crucial. Lung ultrasonography (LU) is a useful diagnostic tool for the neonatologist in the diagnosis of RD; the neonatal lung ultrasonography score (nLUS) can be used in the diagnostic process, but some authors hypothesise that it is also useful for the management of some neonatal RD. The aim of this study is to analyse the changes in nLUS score before (T0) and after (T1) the start of respiratory support with nasal CPAP in neonates over 32 weeks of age with RD. Thirty-three newborns were enrolled in this retrospective study. LU was performed before and after the start of CPAP. The median nLUS scores at T0 and T1 were 9 (IQR 7−12) and 7 (IQR 4−10), respectively, and showed a significant difference (p < 0.001). The magnitude of reduction in nLUS score, expressed as a percentage, was inversely related to the need for subsequent administration of exogenous surfactant. The study suggests the usefulness of the nLUS score in assessing the response to CPAP in neonates over 32 weeks gestational age.

Citing Articles

Effect of different CPAP levels on ultrasound-assessed lung aeration and gas exchange in neonates.

Sartorius V, Loi B, Vivalda L, Regiroli G, De La Rubia-Ortega S, Pezza L Respir Res. 2024; 25(1):375.

PMID: 39420410 PMC: 11488124. DOI: 10.1186/s12931-024-03010-x.

Neonatal point-of-care lung ultrasound: what should be known and done out of the NICU?.

Alonso-Ojembarrena A, Gregorio-Hernandez R, Raimondi F Eur J Pediatr. 2024; 183(4):1555-1565.

PMID: 38315204 DOI: 10.1007/s00431-023-05375-5.

Lung Ultrasound: A Leading Diagnostic Tool.

Demi M, Soldati G Diagnostics (Basel). 2023; 13(10).

PMID: 37238195 PMC: 10217225. DOI: 10.3390/diagnostics13101710.

References

Prontera G, Perri A, Vento G, DAndrea V . Use of Wireless Ultrasound Probe in Isolated Infants: A Case Report of Two SARS-CoV-2-Positive Mothers' Newborns. Neonatology. 2021; 119(1):129-132. PMC: 8678242. DOI: 10.1159/000519712. View

Szymanski P, Kruczek P, Hozejowski R, Wais P . Modified lung ultrasound score predicts ventilation requirements in neonatal respiratory distress syndrome. BMC Pediatr. 2021; 21(1):17. PMC: 7785923. DOI: 10.1186/s12887-020-02485-z. View

Schneider-Kolsky M, Ayobi Z, Lombardo P, Brown D, Kedang B, Gibbs M . Ultrasound exposure of the foetal chick brain: effects on learning and memory. Int J Dev Neurosci. 2009; 27(7):677-83. DOI: 10.1016/j.ijdevneu.2009.07.007. View

Ruoss J, Bazacliu C, Cacho N, De Luca D . Lung Ultrasound in the Neonatal Intensive Care Unit: Does It Impact Clinical Care?. Children (Basel). 2021; 8(12). PMC: 8700415. DOI: 10.3390/children8121098. View

Reuter S, Moser C, Baack M . Respiratory distress in the newborn. Pediatr Rev. 2014; 35(10):417-28. PMC: 4533247. DOI: 10.1542/pir.35-10-417. View

Ramaswamy V, More K, Roehr C, Bandiya P, Nangia S . Efficacy of noninvasive respiratory support modes for primary respiratory support in preterm neonates with respiratory distress syndrome: Systematic review and network meta-analysis. Pediatr Pulmonol. 2020; 55(11):2940-2963. DOI: 10.1002/ppul.25011. View

Ma H, Liu J, Yan W . Accuracy and Reliability of Lung Ultrasound to Diagnose Transient Tachypnoea of the Newborn: Evidence from a Meta-analysis and Systematic Review. Am J Perinatol. 2020; 39(9):973-979. DOI: 10.1055/s-0040-1721134. View

Sweet D, Carnielli V, Greisen G, Hallman M, Ozek E, Te Pas A . European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 Update. Neonatology. 2019; 115(4):432-450. PMC: 6604659. DOI: 10.1159/000499361. View

He L, Sun Y, Sheng W, Yao Q . Diagnostic performance of lung ultrasound for transient tachypnea of the newborn: A meta-analysis. PLoS One. 2021; 16(3):e0248827. PMC: 8006999. DOI: 10.1371/journal.pone.0248827. View

10.

Zong H, Guo G, Liu J, Yang C, Bao L . Wet lung leading to RDS: the lung ultrasound findings and possible mechanisms - a pilot study from an animal mode. J Matern Fetal Neonatal Med. 2020; 34(13):2197-2205. DOI: 10.1080/14767058.2020.1846711. View

11.

Ho J, Subramaniam P, Davis P . Continuous positive airway pressure (CPAP) for respiratory distress in preterm infants. Cochrane Database Syst Rev. 2020; 10:CD002271. PMC: 8094155. DOI: 10.1002/14651858.CD002271.pub3. View

12.

Liu J, Copetti R, Sorantin E, Lovrenski J, Rodriguez-Fanjul J, Kurepa D . Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus. J Vis Exp. 2019; (145). DOI: 10.3791/58990. View

13.

Omran A, AbdAllah N, Ibrahim M, El-Sharkawy S . Lung ultrasound in early diagnosis of neonatal transient tachypnea and its differentiation from other causes of neonatal respiratory distress. J Neonatal Perinatal Med. 2018; 11(3):281-287. DOI: 10.3233/NPM-181796. View

14.

Brat R, Yousef N, Klifa R, Reynaud S, Aguilera S, De Luca D . Lung Ultrasonography Score to Evaluate Oxygenation and Surfactant Need in Neonates Treated With Continuous Positive Airway Pressure. JAMA Pediatr. 2015; 169(8):e151797. DOI: 10.1001/jamapediatrics.2015.1797. View

15.

Kurepa D, Zaghloul N, Watkins L, Liu J . Neonatal lung ultrasound exam guidelines. J Perinatol. 2017; 38(1):11-22. DOI: 10.1038/jp.2017.140. View

16.

Ho J, Subramaniam P, Sivakaanthan A, Davis P . Early versus delayed continuous positive airway pressure (CPAP) for respiratory distress in preterm infants. Cochrane Database Syst Rev. 2020; 10:CD002975. PMC: 8094884. DOI: 10.1002/14651858.CD002975.pub2. View

17.

Raimondi F, Migliaro F, Corsini I, Meneghin F, Pierri L, Salome S . Neonatal Lung Ultrasound and Surfactant Administration: A Pragmatic, Multicenter Study. Chest. 2021; 160(6):2178-2186. DOI: 10.1016/j.chest.2021.06.076. View

18.

Pramanik A, Rangaswamy N, Gates T . Neonatal respiratory distress: a practical approach to its diagnosis and management. Pediatr Clin North Am. 2015; 62(2):453-69. DOI: 10.1016/j.pcl.2014.11.008. View

19.

Miller L, Stoller J, Fraga M . Point-of-care ultrasound in the neonatal ICU. Curr Opin Pediatr. 2019; 32(2):216-227. DOI: 10.1097/MOP.0000000000000863. View

20.

Hogden L, Munger K, Duffek S . Neonatal Respiratory Distress. S D Med. 2021; 74(1):28-35. View