Lung Ultrasound (LUS) in Pre-term Neonates with Respiratory Distress: A Prospective Observational Study

Overview

Journal Lung India

Specialty Pulmonary Medicine

Date 2023 Jan 11

PMID 36629201

Authors

Gouda Ankula P Kartikeswar

Tushar Parikh

Dhyey Pandya

Anand Pandit

Affiliations

Soon will be listed here.

Abstract

Aim: To find out the diagnostic use of lung ultrasound (LUS) in respiratory distress in neonates by taking clinico-radiological (clinical plus X-ray) diagnosis as the gold standard. Secondary objectives were to find out if modified LUS score can predict the need for surfactant therapy.

Methods: A prospective observational study was done in a tertiary care neonatal intensive care unit over a period of 1 year (January-December 2018). All pre-term infants with respiratory distress were screened with LUS and CXR within 2 h of admission and modified LUS score was calculated to find out the lung water content and its correlation with the severity of respiratory distress syndrome (RDS).

Results: In total, 92 neonates were screened during the study period, and 61 were finally diagnosed as RDS. The Kappa statistic between the clinico-radiological diagnosis and LUS diagnosis was 0.639. LUS diagnosis and CXR diagnosis had a Kappa correlation value of 0.786 (95% CI: 0.678-0.983). The most common LUS feature in RDS was pleural line thickening (100%), followed by whiteout lungs (75.4%). The modified LUS score was higher in babies who needed surfactant therapy (median (IQR): 49 (44, 53.5) vs. 29.5 (21, 46)) (P < 0.0001).

Conclusion: Our study shows that LUS in neonatal RDS can predict the severity of the disease, need for surfactant therapy and has good agreement with clinical and Xray diagnosis.

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References

Enghard P, Rademacher S, Nee J, Hasper D, Engert U, Jorres A . Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients. Crit Care. 2015; 19:36. PMC: 4335373. DOI: 10.1186/s13054-015-0756-5. View

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

Lichtenstein D, Lascols N, Meziere G, Gepner A . Ultrasound diagnosis of alveolar consolidation in the critically ill. Intensive Care Med. 2004; 30(2):276-281. DOI: 10.1007/s00134-003-2075-6. View

Liu Md PhD J, Cao Md H, Wang Md H, Kong Md PhD X . The role of lung ultrasound in diagnosis of respiratory distress syndrome in newborn infants. Iran J Pediatr. 2014; 24(2):147-54. PMC: 4268833. View

Sweet D, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R . European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2016 Update. Neonatology. 2016; 111(2):107-125. DOI: 10.1159/000448985. View

Hibbard J, Wilkins I, Sun L, Gregory K, Haberman S, Hoffman M . Respiratory morbidity in late preterm births. JAMA. 2010; 304(4):419-25. PMC: 4146396. DOI: 10.1001/jama.2010.1015. View

Copetti R, Cattarossi L . The 'double lung point': an ultrasound sign diagnostic of transient tachypnea of the newborn. Neonatology. 2007; 91(3):203-9. DOI: 10.1159/000097454. View

Kartikeswar G, Parikh T, Pandya D, Pandit A . Ionizing Radiation Exposure in NICU. Indian J Pediatr. 2019; 87(2):158-160. PMC: 7222152. DOI: 10.1007/s12098-019-03126-9. View

Copetti R, Cattarossi L, Macagno F, Violino M, Furlan R . Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis. Neonatology. 2008; 94(1):52-9. DOI: 10.1159/000113059. View

10.

Edwards M, Kotecha S, Kotecha S . Respiratory distress of the term newborn infant. Paediatr Respir Rev. 2013; 14(1):29-36. DOI: 10.1016/j.prrv.2012.02.002. View

11.

Cattarossi L, Copetti R, Poskurica B . Radiation exposure early in life can be reduced by lung ultrasound. Chest. 2011; 139(3):730-731. DOI: 10.1378/chest.10-2338. View

12.

Corsini I, Parri N, Gozzini E, Coviello C, Leonardi V, Poggi C . Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates. Neonatology. 2018; 115(1):77-84. DOI: 10.1159/000493001. View

13.

Razak A, Faden M . Neonatal lung ultrasonography to evaluate need for surfactant or mechanical ventilation: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2019; 105(2):164-171. DOI: 10.1136/archdischild-2019-316832. View

14.

Liu J, Chen X, Li X, Chen S, Wang Y, Fu W . Lung Ultrasonography to Diagnose Transient Tachypnea of the Newborn. Chest. 2016; 149(5):1269-75. DOI: 10.1016/j.chest.2015.12.024. View

15.

Rachuri H, Oleti T, Murki S, Subramanian S, Nethagani J . Diagnostic Performance of Point of Care Ultrasonography in Identifying the Etiology of Respiratory Distress in Neonates. Indian J Pediatr. 2017; 84(4):267-270. DOI: 10.1007/s12098-016-2288-7. View

16.

Brusa G, Savoia M, Vergine M, Bon A, Copetti R, Cattarossi L . Neonatal Lung Sonography: Interobserver Agreement Between Physician Interpreters With Varying Levels of Experience. J Ultrasound Med. 2015; 34(9):1549-54. DOI: 10.7863/ultra.15.14.08016. View

17.

Hiles M, Culpan A, Watts C, Munyombwe T, Wolstenhulme S . Neonatal respiratory distress syndrome: Chest X-ray or lung ultrasound? A systematic review. Ultrasound. 2017; 25(2):80-91. PMC: 5438053. DOI: 10.1177/1742271X16689374. View

18.

Ahuja C, Saxena A, Sodhi K, Kumar P, Khandelwal N . Role of transabdominal ultrasound of lung bases and follow-up in premature neonates with respiratory distress soon after birth. Indian J Radiol Imaging. 2013; 22(4):279-83. PMC: 3698890. DOI: 10.4103/0971-3026.111480. View