Application Value of a New Lung Ultrasound Scoring Method in Neonatal Respiratory Distress Syndrome Treatment

Abstract We studied a 14-zone lung ultrasound scoring method to quantify the efficiency of pulmonary surfactant treatment and to determine the timing of mechanical ventilation in neonates with neonatal respiratory distress syndrome. In this prospective study, we identified 88 neonates who received pulmonary surfactant replacement therapy. We measured surfactant efficiency using the 14-zone scoring method pre-treatment and at 12 h, 24 h, 48 h, and 72 h post-treatment. The ultrasound score was inversely associated with pulmonary surfactant treatment. We also identified 67 neonates on mechanical ventilation. We applied the scoring method when the infants met criteria for ventilator withdrawal. A comparison of pre-treatment to 12 h post-treatment showed that scoring method was significantly different (t = 4.08, P < 0.05); other scoring methods did not differ (P > 0.05). Thus, the scoring method performed better on withdrawal time. A score of 41.0 was defined as the threshold for risk of withdrawal failure with 92.36% sensitivity and 93.80% specificity, with an area under the curve of 0.955. Conclusion: The new 14-zone lung ultrasound scoring method improved scoring on the efficacy of pulmonary surfactant and had good diagnostic efficiency for timing the removal of mechanical ventilation in neonatal respiratory distress syndrome.

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Lung ultrasound in diagnosing neonatal respiratory distress syndrome: a meta-analysis

Paediatrica Indonesiana ◽

10.14238/pi59.6.2019.340-8 ◽

2019 ◽

Vol 59 (6) ◽

pp. 340-8

Author(s):

Hanum Ferdian ◽

Dian Ibnu Wahid ◽

Samad Samad ◽

Anggun Esti Wardani ◽

Guntur Surya Alam ◽

...

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Sensitivity And Specificity ◽

Diagnostic Tool ◽

Distress Syndrome ◽

Lung Ultrasound ◽

Meta Analysis ◽

Neonatal Respiratory Distress Syndrome ◽

Inclusion Criteria ◽

Neonatal Respiratory Distress

Background Neonatal respiratory distress syndrome (NRDS) is commonly diagnosed by clinical sign and symptoms, blood gas analysis, and chest x-ray. In the past, lung ultrasound (LUS) was not standard for NRDS examination. Many studies show that ultrasound diagnostic tool for NRDS is accurate, reliable, low cost, easy to use, and safe because due to no ionizing radiation. Objective To determine the sensitivity and specificity of LUS in diagnosing NRDS. Methods This meta-analysis study was conducted LUS as a diagnostic tool for NRDS. Inclusion criteria were all studies from PubMed, Embase, and The Cochrane Library, without any limitation on published journals, as well as using keywords or search terms of ultrasound, neonatal, and respiratory distress syndrome. Statistical analysis was undertaken using MedCalc® version 18.2 software. Results Seven studies with a total of 580 patients met the inclusion criteria. Proportional meta-analysis obtained random effects models, with total sensitivity of LUS was 97.2% (95% CI for I2 74.24 to 92.88; P<0.0001) and specificity of LUS was 94.8% (95% CI for I2 88.60 to 98.03; P<0.00001). Conclusion Lung ultrasound should be considered as a diagnostic tool for NRDS because it is high in sensitivity and specificity, inexpensive, safe, as well as limited radiation exposure.

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Lung Ultrasound for the Diagnosis of Neonatal Respiratory Distress Syndrome

Ultrasound Quarterly ◽

10.1097/ruq.0000000000000490 ◽

2020 ◽

Vol 36 (2) ◽

pp. 102-110

Author(s):

Jiangfeng Wu ◽

Yunlai Wang ◽

Anli Zhao ◽

Zhengping Wang

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Lung Ultrasound ◽

Neonatal Respiratory Distress Syndrome ◽

Neonatal Respiratory Distress

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Bedside lung ultrasound guided the treatment of neonatal respiratory distress syndrome by mechanical ventilation

Pediatric Dimensions ◽

10.15761/pd.1000194 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Zhao Chun ◽

Cheng Yingying ◽

Xu Linger ◽

Fu Huihui ◽

Yuan Yebo

Keyword(s):

Mechanical Ventilation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Lung Ultrasound ◽

Neonatal Respiratory Distress Syndrome ◽

Ultrasound Guided ◽

Neonatal Respiratory Distress

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Neonatal respiratory distress syndrome: Chest X-ray or lung ultrasound? A systematic review

Ultrasound ◽

10.1177/1742271x16689374 ◽

2017 ◽

Vol 25 (2) ◽

pp. 80-91 ◽

Cited By ~ 28

Author(s):

Matthew Hiles ◽

Anne-Marie Culpan ◽

Catriona Watts ◽

Theresa Munyombwe ◽

Stephen Wolstenhulme

Keyword(s):

Respiratory Distress Syndrome ◽

Diagnostic Accuracy ◽

Respiratory Distress ◽

Distress Syndrome ◽

Lung Ultrasound ◽

Neonatal Respiratory Distress Syndrome ◽

Reference Standard ◽

Air Leak ◽

Gestation Age ◽

Neonatal Respiratory Distress

Background and aim Neonatal respiratory distress syndrome is a leading cause of morbidity in preterm new-born babies (<37 weeks gestation age). The current diagnostic reference standard includes clinical testing and chest radiography with associated exposure to ionising radiation. The aim of this review was to compare the diagnostic accuracy of lung ultrasound against the reference standard in symptomatic neonates of ≤42 weeks gestation age. Methods A systematic search of literature published between 1990 and 2016 identified 803 potentially relevant studies. Six studies met the review inclusion criteria and were retrieved for analysis. Quality assessment was performed before data extraction and meta-analysis. Results Four prospective cohort studies and two case control studies included 480 neonates. All studies were of moderate methodological quality although heterogeneity was evident across the studies. The pooled sensitivity and specificity of lung ultrasound were 97% (95% confidence interval [CI] 94–99%) and 91% (CI: 86–95%) respectively. False positive diagnoses were made in 16 cases due to pneumonia (n = 8), transient tachypnoea (n = 3), pneumothorax (n = 1) and meconium aspiration syndrome (n = 1); the diagnoses of the remaining three false positive results were not specified. False negatives diagnoses occurred in nine cases, only two were specified as air-leak syndromes. Conclusions Lung ultrasound was highly sensitive for the detection of neonatal respiratory distress syndrome although there is potential to miss co-morbid air-leak syndromes. Further research into lung ultrasound diagnostic accuracy for neonatal air-leak syndrome and economic modelling for service integration is required before lung ultrasound can replace chest radiography as the imaging component of the reference standard.

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