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

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mohammed Ibrahim ◽  
Ahmed Omran ◽  
Mostafa Ibrahim ◽  
Nouran Bioumy ◽  
Sonya El-Sharkawy

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.


2020 ◽  
Vol 180 (1) ◽  
pp. 137-146
Author(s):  
Nora Tusor ◽  
Angela De Cunto ◽  
Yousef Basma ◽  
John L. Klein ◽  
Virginie Meau-Petit

AbstractNo consensus exists regarding the definition of ventilator-associated pneumonia (VAP) in neonates and reliability of chest X-ray (CXR) is low. Lung ultrasound (LU) is a potential alternative diagnostic tool. The aim was to define characteristics of VAP in our patient population and propose a multiparameter score, incorporating LU, for VAP diagnosis. Between March 25, 2018, and May 25, 2019, infants with VAP were identified. Clinical, laboratory and microbiology data were collected. CXRs and LU scans were reviewed. A multiparameter VAP score, including LU, was calculated on Day 1 and Day 3 for infants with VAP and for a control group and compared with CXR. VAP incidence was 10.47 episodes/1000 ventilator days. LU and CXR were available for 31 episodes in 21 infants with VAP, and for six episodes in five patients without VAP. On Day 1, a VAP score of > 4, and on Day 3 a score of > 5 showed sensitivity of 0.94, and area under the curve of 0.91 and 0.97, respectively. AUC for clinical information only was 0.88 and for clinical and CXR 0.85.Conclusion: The multiparameter VAP score including LU could be useful in diagnosing VAP in neonates with underlying lung pathology. What is Known:• Ventilator associated pneumonia (VAP) is common in infants on the neonatal unit and is associated with increased use of antibiotics, prolonged ventilation and higher incidence of chronic lung disease.• Commonly used definitions of VAP are difficult to apply in neonates and interpretation of chest X-ray is challenging with poor inter-rater agreement in patients with underlying chronic lung disease. What is New:• The multiparameter VAP score combining clinical, microbiology and lung ultrasound (LU) data is predictive for VAP diagnosis in preterm infants with chronic lung disease.• LU findings of VAP in neonates showed high inter-rater agreement and included consolidated lung areas, dynamic bronchograms and pleural effusion.



2020 ◽  
Vol 8 (1) ◽  
pp. 52-57
Author(s):  
Poorvi ◽  
Roshan Ann Oommen ◽  
Santosh T Soans

Background: Transient tachypnea of the newborn (TTNB) is one of the most common causes of perinatal dyspnea and is traditionally diagnosed by chest x-ray. Lung ultrasound is an upcoming tool which is being proved in recent studies to have a better diagnostic capability with the main characteristic feature being the Double Lung Point. Aims & objectives: To define ultrasonographic appearance of TTNB, evaluate its clinical relevance for early diagnosis and compare the outcome with xray and to assess the diagnostic ability of Double lung point.Subjects and Methods:All newborns presenting with tachypnea within 4 hours of life in 1 ½ years of study period. (November 2017-May 2019) were enrolled for study. Methods of collection of data: All newborns fulfilling the inclusion criteria were included as study subjects, At same time CHEST XRAY and LUS were done. Statistical analysis: Fisher’s exact test was used as test of significance for qualitative data. Continuous data was represented as mean and standard deviation. Mann Whitney U test and Kruskul-wallis test was used for subgroup analysis. P value of <0.05 was considered as statistically significant.Result:In study period of 1 ½ years 99 cases which were admitted in NICU with respiratory distress meeting the criteria were included. 60 cases were diagnosed to have TTNB, 34 RDS & 5 Pneumonia. Chest xray and Lung ultrasound (LUS) of these 60 TTNB cases were compared . LUS of TTNB and other cases was also compared for presence of double lung point (DLP). The sensitivity & specificity of DLP in diagnosis of TTNB was noted to be 68 % & 100 % respectively with 100 % Positive predictive value. Thus confirming LUS to be a more reliable diagnostic tool than x-ray.Conclusion:Therefore LUS could be used widely in NICU as 1st line of diagnostic medium in diagnosis of various respiratory conditions and early initiation of treatment accordingly.



2021 ◽  
pp. 115152
Author(s):  
Mahbubunnabi Tamal ◽  
Maha Alshammari ◽  
Meernah Alabdullah ◽  
Rana Hourani ◽  
Hossain Abu Alola ◽  
...  


Author(s):  
Ryan C. Gibbons ◽  
Mark Magee ◽  
Harry Goett ◽  
James Murrett ◽  
Jessica Genninger ◽  
...  


2012 ◽  
Vol 52 (4) ◽  
pp. 233
Author(s):  
Neni Sumarni ◽  
Muhammad Sholeh Kosim ◽  
Mohammad Supriatna ◽  
Eddy Sudijanto

Background Ventilator􀁖associated pneumonia (VAP) is anosocomial infection in patients who have received mechanicalventilation (MV), either by endotracheal intubation ortracheostomy, for more than 48 hours. YAP represents 80% ofall hospital􀁖acquired pneumonias. VAP incidence varies from5.1 %􀁖33.3%. The modified clinical pulmonary infection scoreis a criteria for diagnosing suspected YAP and typically includesradiographic evidence. YAP is associated with significantmorbidity and mortality.Objective To determine the relationship between chest x􀁖rayfindings and outcomes in children Mth suspected VAP.Methods This retrospective study was held in Dr. Kariadi Hospitalfrom January - December 2010. Data was collected from medicalrecords of pediatric ICU (PICU) patients with suspected VAP.Chest x􀁖ray findings and patient outcomes were recorded. X􀁖rayfindings were assessed by the on􀁖duty radiologist. Chi square testwas used for statistical analysis.Results Subjects were 30 children consisting of 14 males and 16females. Patient outcomes were 23 patients survived and 7 patientsdied. Chest x􀁖ray findings were categorized into the followinggroups and compared to patient survivability: diffuse infiltrates76.7% (OR􀁗0.694; P􀁗0.532; 95% CI 0.102 to 4.717), localhedinfiltrates 13.3% (OR􀁗4.200; P􀁗 0.225; 95% CI 0.470 t037.49),and no infiltrates 10% (OR􀁗 1.222; P􀁗 0.436; 95% CI 0.593 to0.926). None of the x􀁖ray findings had a significant correlationto patient outcomes.Conclusion There was no significant relationship between chestx􀁖ray findings and outcomes in children with suspected VAP.[Paediatr rndones. 2012;52:233-8].



2021 ◽  
Vol 74 (8) ◽  
pp. 1783-1788
Author(s):  
Khrystyna O. Pronyuk ◽  
Liudmyla O. Kondratiuk ◽  
Andrii D. Vysotskyi ◽  
Olga A. Golubovska ◽  
Iryna M. Nikitina

The aim: To optimize diagnostic of pathological processes in lungs affected by COVID-19, dynamic monitoring and clinical decision making using lung ultrasound in limited resources settings. Materials and methods: Between the onset of pandemics and January 2021, approximately 9000 patients have been treated for confirmed COVID-19 in the Olexandrivska Clinical Hospital. Assessment of all hospitalized patients included hematology, chemistries and proinflammatory cytokines – IL-6, CRP, procalcitonin, ferritin. Diagnosis was confirmed by PCR for SARS-CoV-2 RNA. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. Lung ultrasound was proactively utilized to assess the type and extent of lung damage and to monitor the progress of disease in patients hospitalized into the ICU and Infection Unit (n=135). Ultrasound findings were recorded numerically based on scales. Results: In the setting of СOVID-19, bedside lung ultrasound has been promptly recognized as a tool to diagnose and monitor the nature and extent of lung injury. Lung ultrasound is a real time assessment, which helps determine the nature of a pathologic process affecting lungs. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. Described in article data is collected in one of the biggest facility that deals with COVID-19. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. The cases presented in the paper indicate potential advantages to the use of ultrasound in limited resource healthcare settings, especially when the risk of transportation to CT outweighs the value of information obtained. Conclusions: Grading of ultrasonographic findings in the lungs was sufficient for both initial assessment with identification of high risk patients, and routine daily monitoring. Hence, lung ultrsound may be used to predict deterioration, stratify risks and make clinical decisions.



2018 ◽  
Vol 18 (74) ◽  
pp. 193-197 ◽  
Author(s):  
Sławomir Jaszczołt ◽  
◽  
Tomasz Polewczyk ◽  
Marta Dołęga-Kozierowska ◽  
Mariusz Woźniak ◽  
...  
Keyword(s):  
X Ray ◽  


2021 ◽  
pp. 3-18
Author(s):  
Abdel Rahman M. Attia ◽  
Sally M. ElGhamrawy


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