Lung Ultrasonography Decreases Radiation Exposure in Newborns with Respiratory Distress

Abstract Chest X-ray(CXR) is commonly used as a first line imaging method to diagnose the reason of respiratory distress in NICUs.Lung ultrasound is a new diagnostic tool for lung imaging. We aimed to determine the decrease in the number of CXRs on the first day of life in newborns with respiratory distress,with the use of lung ultrasonography. From January 2019 to June 2020,104 newborn infants hospitalized in the NICU with respiratory distress on the first day of life enrolled in this study(ClinicalTrials.govIdentifier NCT04722016).We used ultrasound as the first line technique for lung imaging.CXR was taken to determine endotracheal tube and umbilical catheter position or if considered necessary by the physician in charge of the infant.We calculated decreased number of CXR for every patient and evaluated the estimated decrease in radiation exposure. 104 neonates with median 36 weeks(25–40)gestational age and birth weight 2410gr(600–4100) enrolled in the study.Seventy(67,3%)of these babies were male.In the study group,24(23,1 %)patients were diagnosed with respiratory distress syndrome(RDS),49(47,1 %) patients with transient tachypnea of newborn(TTN),27(26 %) with pneumonia,4(3,8 %)with congenital heart diseases.Lung ultrasonography were performed 210 times for all infants,but CXRs were performed a total of only 107 times.CXR wasnot taken in 27 of the patients with a diagnosis of TTN,in 2 of the patients with a diagnosis of congenital pneumonia,and in one of the patients with congenital heart disease.The rate of patients who have never had a chest x-ray was 28,8%.Conclusions:We observed that usage of lung ultrasonography decreased the number of chest X-ray and radiation exposure in newborns with respiratory distress.

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Lung ultrasonography score versus chest X-ray score to predict surfactant administration in newborns with respiratory distress syndrome

Pediatric Pulmonology ◽

10.1002/ppul.24076 ◽

2018 ◽

Vol 53 (9) ◽

pp. 1231-1236 ◽

Cited By ~ 10

Author(s):

Alessandro Perri ◽

Riccardo Riccardi ◽

Rossella Iannotta ◽

Domenico V. Di Molfetta ◽

Roberta Arena ◽

...

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Lung Ultrasonography ◽

X Ray ◽

Chest X Ray ◽

Surfactant Administration

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A Successful Medical Treatment of Necrotizing Pneumonia in a Pediatric Patient

Case Reports in Pediatrics ◽

10.1155/2020/8875119 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Herlina Uinarni ◽

Felicia Nike ◽

Andi Dwi Bahagia

Keyword(s):

Antibiotic Therapy ◽

Respiratory Distress ◽

Medical Treatment ◽

Chest Ct ◽

Lung Ultrasonography ◽

Necrotizing Pneumonia ◽

Intravenous Antibiotic ◽

X Ray ◽

Chest X Ray

Necrotizing pneumonia is a rare, serious complication of pneumonia in children. We present a case of a 20-month-old girl presenting with respiratory distress which later be diagnosed with necrotizing pneumonia. In this paper, we highlight the role of imaging such as chest X-ray, chest CT, and lung ultrasonography for diagnosis and the importance of intravenous antibiotic therapy for better outcome.

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Lung Ultrasonography Versus Chest X Ray for Diagnosing Pneumonia in Children with Fever and Respiratory Distress: A Prospective Blind Study

American Journal of Pediatrics ◽

10.11648/j.ajp.20180401.14 ◽

2018 ◽

Vol 4 (1) ◽

pp. 15 ◽

Cited By ~ 1

Author(s):

Rania Salah El Zayat

Keyword(s):

Respiratory Distress ◽

Blind Study ◽

Lung Ultrasonography ◽

X Ray ◽

Chest X Ray

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Faculty Opinions recommendation of Performance of ultralow-dose CT with iterative reconstruction in lung cancer screening: limiting radiation exposure to the equivalent of conventional chest X-ray imaging.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726104848.793525333 ◽

2016 ◽

Author(s):

Stefan Bielack

Keyword(s):

Lung Cancer ◽

Cancer Screening ◽

Radiation Exposure ◽

Iterative Reconstruction ◽

Lung Cancer Screening ◽

Ultralow Dose ◽

X Ray ◽

X Ray Imaging ◽

Chest X Ray

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Spontaneous Pneumomediastinum: Uncommon Cause of Air Leak in Late Preterm Neonate

Journal of Neonatology ◽

10.1177/09732179211023763 ◽

2021 ◽

Vol 35 (2) ◽

pp. 93-94

Author(s):

Jyotsna Bhushan ◽

Shagufta Iqbal ◽

Abhishek Chopra

Keyword(s):

Respiratory Distress ◽

Conservative Management ◽

Preterm Neonate ◽

Late Preterm ◽

Intravenous Fluids ◽

X Rays ◽

Blood Gas ◽

X Ray ◽

Spontaneous Pneumomediastinum ◽

Chest X Ray

A clinical case report of spontaneous pneumomediastinum in a late-preterm neonate, chest x-ray showing classical “spinnaker sail sign,” which was managed conservatively and had excellent prognosis on conservative management. Respiratory distress in a preterm neonate is a common clinical finding. Common causes include respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax. Pneumomediastinum is not very common cause of respiratory distress and more so spontaneous pneumomediastinum. We report here a preterm neonate with spontaneous pneumomediastinum who had excellent clinical recovery with conservative management. A male baby was delivered to G3P1A1 mother at 34 + 6 weeks through caesarean section done due to abruptio placenta. Apgar scores were 8 and 9. Maternal antenatal history was uneventful and there were no risk factors for early onset sepsis. Baby had respiratory distress soon after birth with Silverman score being 2/10. Baby was started on oxygen (O2) by nasal prongs through blender 0.5 l/min, FiO2 25%, and intravenous fluids. Blood gas done was normal. Possibility of transient tachypnea of newborn or mild hyaline membrane disease was kept. Respiratory distress increased at 20 h of life (Silverman score: 5), urgent chest x-ray done revealed “spinnaker sign” suggestive of pneumomediastinum, so baby was shifted to O2 by hood with FiO2 being 70%. Blood gas repeated was normal. Baby was managed conservatively on intravenous fluids and O2 by hood. Baby was gradually weaned off from O2 over next 5 days. As respiratory distress decreased, baby was started on orogastric feed, which baby tolerated well and then was switched to oral feeds. Serial x-rays showed resolution of pneumomediastinum. Baby was discharged on day 7 of life in stable condition on breast feeds and room air.

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Acute Mitral Regurgitation: an important cause of respiratory distress

Acute Medicine Journal ◽

10.52964/amja.0598 ◽

2016 ◽

Vol 15 (1) ◽

pp. 30-32

Author(s):

Legate Philip ◽

◽

Neil Andrews ◽

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Respiratory Distress ◽

Severe Mitral Regurgitation ◽

Shortness Of Breath ◽

Valve Repair ◽

X Ray ◽

Clinical Presentations ◽

Acute Mitral Regurgitation ◽

Chest X Ray

Acute mitral regurgitation (acute MR) is a rare cause of acute respiratory distress, which can present diagnostic challenges. We present the case of a 57 year old man who developed acute shortness of breath subsequently associated with fever, raised white cells and elevated CRP. Chest x-ray revealed unilateral shadowing and he was treated for pneumonia, despite the finding of severe mitral regurgitation on echo. Failure to respond to antibiotic treatment following 3 weeks on ITU led to the consideration of acute MR as the cause of his symptoms and he responded well to diuretics. He subsequently underwent mitral valve repair. The causes and clinical presentations of this condition are discussed.

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Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation

Paediatrica Indonesiana ◽

10.14238/pi53.1.2013.6-11 ◽

2013 ◽

Vol 53 (1) ◽

pp. 6

Author(s):

Indah Nurhayati ◽

Muhammad Supriatna ◽

Kamilah Budhi Raharjani ◽

Eddy Sudijanto

Keyword(s):

Mechanical Ventilation ◽

Retrospective Study ◽

Pleural Effusion ◽

Respiratory Distress ◽

Pulmonary Edema ◽

Patient Outcomes ◽

Morbidity And Mortality ◽

Chi Square ◽

X Ray ◽

Chest X Ray

Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonarydisease as underlying conditions. Mechanical ventilation may beused to limit morbidity and mortality in children with respiratoryfailure.Objective To assess a correlation between chest x-ray findingsand outcomes of patients with mechanical ventilation.Methods This retrospective study was held in Dr. KariadiHospital, Semarang, Indonesia. Data was collected from themedical records of children admitted to the PICU from Januaryto December 2010, who suffered from respiratory distress andused mechanical ventilation. We compared chest x-ray findings tothe outcomes of patients. Radiological expertise was provided byradiologists on duty at the time. Chi-square and logistic regressiontests were used for statistical analysis.Results There were 63 subjects in our study, consisting of 28 malesand 35 females. Patient outcomes were defined as survived or died,43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-rayfindings revealed the following conditions: bronchopneumonia48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;95%CI 0.03 to 7 .62). None of the chest x-ray findings significantlycorrelated to patient outcomes.Conclusion Chest x-ray findings do not correlate to patientoutcomes in pediatric subjects with mechanical ventilation inthe PICU of Dr. Kariadi Hospital, Semarang, Indonesia.

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DOZ047.79: Bronchoscopic treatment of plastic bronchitis in children

Diseases of the Esophagus ◽

10.1093/dote/doz047.79 ◽

2019 ◽

Vol 32 (Supplement_1) ◽

Author(s):

M Y Erdas ◽

N Valiyev ◽

K K Cerit ◽

Y Gokdemir ◽

G Kiyan

Keyword(s):

Respiratory Distress ◽

Rare Condition ◽

Airway Disease ◽

Underlying Disease ◽

Bronchial Tree ◽

X Rays ◽

Plastic Bronchitis ◽

Left Hemithorax ◽

X Ray ◽

Chest X Ray

Abstract Purpose Plastic bronchitis or cast bronchitis is a rare condition characterized by the formation of large gelatinous or rigid airway casts. Classification of plastic bronchitis is done by disease association and cast histology. This rare condition can cause airway obstruction and there is no standardized treatment. Here are presented two cases with plastic bronchitis treated by bronchoscopic removal of casts in our clinic. Patients Case 1: A 9-year-old boy presented with wheezing, cough, and respiratory distress. He expectorated the cast spontaneously and the cast was misdiagnosed as germinative membrane of a hydatid cyst at the previous center. Total collapse of the left hemithorax was seen on chest X-ray. Any underlying disease was not detected. The plastic-like solid structure was detected and easily extracted from the bronchial tree. Pathology results of the casts were eosinophilic mucoid casts. The patient experienced three bronchoscopic removals and had no recurrence thereafter for two years. Case 2: A 7-year-old girl presented with persistent cough and respiratory distress. The patient was referred to our center with the diagnosis of foreign body aspiration. Total collapse of the right middle and lower segment and partial collapse of the upper segment were seen on chest X-ray. Previously, she was diagnosed with reactive airway disease. The plastic-like semisolid structure was detected during bronchoscopy its extraction from the bronchial tree was not easy but was possible. Pathology results were eosinophilic mucoid and fibrinotic casts. This patient still needs bronchoscopy for cast removal after 12 bronchoscopic removals but her symptoms and bronchoscopy findings have regressed with time. Conclusion Bronchoscopic extraction of casts provides fast improvement of patients’ symptoms and postoperative chest X-rays, but recurrence of cast formation is common. Nevertheless, it is the mostly chosen therapy in the literature. Further researches in this area are required.

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Laryngo-Tracheal Displacement and Respiratory Distress in an Infant with Congenital Thymic Hyperplasia

ISRN Pulmonology ◽

10.5402/2011/659103 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Michael Wolff ◽

Süha Demirakca ◽

Anna Kristina Kilian ◽

Horst Schroten ◽

Tobias Tenenbaum

Keyword(s):

Young Children ◽

Respiratory Distress ◽

Corticosteroid Therapy ◽

Clinical Symptoms ◽

Thymic Hyperplasia ◽

Feeding Disorder ◽

X Ray ◽

Chest X Ray

Thymic hyperplasia is usually an asymptomatic condition observed in infancy. A five-week-old boy presented with respiratory distress and feeding disorder, in which chest X-ray and bronchoscopy revealed a strong laryngotracheal displacement. Sonography and MRI confirmed the diagnosis of a thymic hyperplasia. Corticosteroid therapy led to improvement of clinical symptoms. Thymic hyperplasia may lead to laryngo-tracheal displacement and respiratory distress in neonates and young children.

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