Case Report: Neonatal Massive Pneumothorax Resulting in Compression Atelectasis Treated by Ultrasound-Guided Pleural Puncture Therapy: A Typical Case Based on Lung Ultrasound Finding

Atelectasis is a complication of different pulmonary diseases; however, neonatal compression atelectasis due to pneumothorax is rarely reported in the literature. Recently, we encountered a typical case of atelectasis. A preterm infant was admitted to the neonatal intensive care unit owing to severe respiratory distress. Lung ultrasound examination confirmed severe pneumothorax and large area of atelectasis. Lung re-expansion occurred when the air was drained from the pleural cavity.

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Lung Ultrasound: new Opportunities for a Cardiologist

Kardiologiia ◽

10.18087/cardio.2020.1.n617 ◽

2020 ◽

Vol 60 (1) ◽

pp. 81-92

Author(s):

A. Z. Arystan ◽

Y. T. Khamzina ◽

V. V. Benberin ◽

D. V. Fettser ◽

Y. N. Belenkov

Keyword(s):

Lung Ultrasound ◽

Ultrasound Examination ◽

Cost Effective ◽

Diagnostic Value ◽

Ultrasound Finding ◽

Time Saving ◽

X Ray ◽

Cardiac Decompensation ◽

Chest X Ray

This review focused on ultrasound examination of lungs, a useful complement to transthoracic echocardiography (EchoCG), which is superior to chest X-ray in the diagnostic value. The lung acoustic window always remains open and allows obtaining high-quality images in most cases. For a cardiologist, the major points of the method application are determination of pleural effusion and lung congestion. This method has a number of advantages: it is time-saving; cost-effective; portable and accessible; can be used in a real-time mode; not associated with radiation; reproducible; and highly informative. The ultrasound finding of wet lungs would indicate threatening, acute cardiac decompensation long before appearance of clinical, auscultative, and radiological signs of lung congestion. Modern EchoCG should include examination of the heart and lungs as a part of a single, integrative ultrasound examination.

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Utility of Perioperative Lung Ultrasound in Pediatric Cardiac Surgery

Anesthesiology ◽

10.1097/aln.0000000000002069 ◽

2018 ◽

Vol 128 (4) ◽

pp. 718-727 ◽

Cited By ~ 22

Author(s):

In-Kyung Song ◽

Eun-Hee Kim ◽

Ji-Hyun Lee ◽

Pyoyoon Kang ◽

Hee-Soo Kim ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cardiac Surgery ◽

Lung Ultrasound ◽

Ultrasound Examination ◽

Recruitment Maneuver ◽

Intervention Group ◽

Pulmonary Complications ◽

Control Group ◽

Postoperative Pulmonary Complications ◽

Ultrasound Guided

Abstract Background Pediatric cardiac patients are at risk for perioperative respiratory insufficiency. The objective of this study was to assess the utility of perioperative lung ultrasound examination in pediatric cardiac surgery. Methods In this randomized, controlled trial, children (5 yr old or younger) undergoing cardiac surgery were allocated into a control (n = 61) or intervention (n = 61) group. The control group received only lung ultrasound examinations at the end of surgery and 6 to 12 h after surgery. The intervention group received lung ultrasound examinations and an ultrasound-guided recruitment maneuver depending on ultrasound findings after inducing anesthesia, at the end of surgery, and 6 to 12 h after surgery. Primary outcomes were incidences of intra- and postoperative desaturation, and postoperative pulmonary complications. Multiple comparisons were corrected (P ≤ 0.017) in the primary outcome analysis. Results Of the 120 children included in the analysis, postoperative desaturation (64% vs. 27%; P < 0.001; odds ratio [OR], 0.210; 95% CI, 0.097 to 0.456) occurred more in the control group. The incidences of intraoperative desaturation (36% vs. 19%; P = 0.033; OR, 0.406; 95% CI, 0.176 to 0.939) and postoperative pulmonary complications (12% vs. 3%; P = 0.093; OR, 0.271; 95% CI, 0.054 to 1.361) were similar between the groups. Lung ultrasound scores were better in the intervention group than in the control group. Duration of mechanical ventilation was longer in the control group than in the intervention group (38 ± 43 vs. 26 ± 25 h; 95% CI of mean difference, 0 to 25; P = 0.048). Conclusions Perioperative lung ultrasound examination followed by ultrasound-guided recruitment maneuver helped decrease postoperative desaturation events and shorten the duration of mechanical ventilation in pediatric cardiac patients.

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Hérnia Diafragmática Congênita: Relato de Caso/ Congenital Diaphragmatic Hernia: Case Report

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v3i1.306 ◽

1970 ◽

Vol 3 (1) ◽

pp. 27-34

Author(s):

Lucas Tavares Dos Santos ◽

Tânia Massini Evangelista

Keyword(s):

Case Report ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Neonatal Intensive Care ◽

Esophageal Hiatus ◽

Bochdalek Hernia ◽

Severe Respiratory Distress ◽

X Ray ◽

Venous Catheterization ◽

Terapia Intensiva

Introdução: A hérnia diafragmática congênita é a falha do fechamento embrionário do músculo diafragmático, resultando em um defeito de continuidade. Esta patologia pode ocorrer pela passagem de estruturas do abdome através de um defeito no diafragma, ou haver herniação parcial do estômago através do hiato esofágico, paralisia frênica com deslocamento do conteúdo abdominal para cima, mas sem herniação, e, eventração do diafragma. Casuística: Foi relatado um caso de hérnia diafragmática congênita, hérnia de Bochdalek, em um recém – nascido do sexo feminino, que nos ultra-sonografias da gestante apresentavam sem alterações. O diagnóstico da patologia foi feito apenas após a realização de raios-X de tórax e abdome para confirmar a posição do cateterismo umbilical venoso. Discussão/Conclusão: A apresentação clínica da hérnia de diafragmática congênita inclui desconforto respiratório moderado a grave com repercussão sistêmica. O diagnóstico, em cerca de 80% dos casos, é feito por ultrassom pré-natal. O tratamento proposto foi intubação endotraqueal com ventilação mecânica e programação para correção cirúrgica da hérnia. Após correção cirúrgica da patologia, a paciente permaneceu na unidade de terapia intensiva neonatal por 21 dias para acompanhamento de pós – operatório e intercorrências na evolução. Palavras-chave: hérnia diafragmática congênita, recém-nascido, hérnia de BochdalekABSTRACTIntroduction: Congenital diaphragmatic hernia is the failure of embryonic closure of the diaphragm, resulting in a lack of continuity. This condition can occur by passing structures of the abdomen through a defect in the diaphragm, or be part herniation of the stomach through the esophageal hiatus, phrenic paralysis with displacement of abdominal contents up but no herniation, and eventration of the diaphragm. Case Report: We report a case congenital diaphragmatic hernia, such as Bochdalek hernia, in a new - born female that in ultrasounds of pregnant women showed without change. The diagnosis of the disease was made only after conducting X-ray of the chest and abdomen to confirm the position of umbilical venous catheterization. Discussion/Conclusion: Clinical presentation of congenital diaphragmatic hernia includes moderate to severe respiratory distress with systemic repercussions. The diagnosis in about 80% of the cases is done by ultrasound prenatally. The proposed treatment was endotracheal intubation with mechanical ventilation and programming for surgical correction of the hernia. After surgical pathology, the patient remained in neonatal intensive care unit for 21 days to monitor post - operative complications and evolution. Keywords: congenital diaphragmatic hernia, newborn, Bochdalek hernia

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Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211132 ◽

2021 ◽

pp. 1-13

Author(s):

Ying-Hua Sun ◽

Lin Yuan ◽

Yang Du ◽

Jian-Guo Zhou ◽

Sam Bill Lin ◽

...

Keyword(s):

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Neonatal Intensive Care ◽

Lung Ultrasound ◽

Imaging Method ◽

Chronic Lung Diseases ◽

Pleural Line ◽

Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P < 0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P < 0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.

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Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists

10.1093/med/9780190081416.001.0001 ◽

2021 ◽

Keyword(s):

Lung Ultrasound ◽

Central Line ◽

Arterial Line ◽

Ultrasound Guided ◽

Pediatric Airway ◽

Skill Sets ◽

Additional Information ◽

Line Placement ◽

Extensive Training ◽

Radiologic Imaging

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists is intended as a ready resource for both experts and novices. It will be useful to those with extensive training and experience as well as beginners and those with distant experience or training. A wealth of knowledge in the human factors of procedure design and use has been applied throughout to ensure that desired information can be easily located, that steps are clearly identified and comprehensible, and that additional information of high relevance to procedure completion is co-located and salient. This book begins with the basics but quickly progresses to advanced skill sets. It is divided into four parts. Part I starts with a primer on ultrasound machine functionality as well as procedural chapters on lung ultrasound to detect a mainstem intubation or pneumothorax and gastric ultrasound to assess gastric contents in incompletely fasted patients. Part II covers ultrasound guided peripheral intravenous line placement through the incremental advancement method, ultrasound guided arterial line placement, and ultrasound guided central line placement. Part III details several ultrasound guided regional anesthesia techniques. Part IV covers radiology of the pediatric airway and mediastinum, lungs, gastrointestinal, genitourinary, musculoskeletal, and neurologic systems.

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Double-Blind, Randomized Trial of a Calf Lung Surfactant Extract Administered at Birth to Very Premature Infants for Prevention of Respiratory Distress Syndrome

PEDIATRICS ◽

10.1542/peds.76.4.593 ◽

1985 ◽

Vol 76 (4) ◽

pp. 593-599 ◽

Cited By ~ 4

Author(s):

Donald L. Shapiro ◽

Robert H. Notter ◽

Frederick C. Morin ◽

Karl S. Deluga ◽

Leonard M. Golub ◽

...

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Premature Infants ◽

Neonatal Intensive Care ◽

Distress Syndrome ◽

Lung Surfactant ◽

Treated Group ◽

Control Group ◽

Double Blind ◽

Severe Respiratory Distress

Organic solvent extraction of surfactant obtained by lavage of calf lungs yields a highly surfaceactive material. A double blind, randomized clinical trial to determine the effect of this material on respiratory distress syndrome in premature infants was initiated in the Neonatal Intensive Care Unit at the University of Rochester in December 1983. Infants 25 to 29 weeks gestational age were eligible for entry into the trial. At the time of this interim analysis 32 patients had been randomly selected and entered into the trial, 16 surfactant-treated patients and 16 in a control group who received only saline. At birth, intrapulmonary instillation of the calf lung surfactant extract dispersed in saline or saline alone occurred in the delivery room immediately after intubation and prior to ventilation; infants were then ventilated and treated as usual. At 6, 12, 24, 48, and 72 hours after birth, the severity of respiratory distress was categorized as either minimal, intermediate, or severe based on oxygen and mean airway pressure requirements. Differences observed at six hours after birth were of marginal significance, but at 12 and 24 hours the surfactant-treated group had significantly (P < .01) less severe respiratory distress compared with the control group. Differences between treated and control infants were not statistically significant at 48 and 72 hours after birth. In four surfactant-treated infants the severity of respiratory distress worsened between 24 and 48 hours after birth, suggesting that one dose of surfactant at birth may not be sufficient for some infants.

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P5677The long-lasting symptomatic benefit induced by lung ultrasound-guided therapeutic thoracentesis in refractory congestive heart failure: a retrospective cohort study

European Heart Journal ◽

10.1093/eurheartj/ehy566.p5677 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

A Lazarevic ◽

M Dobric ◽

S Krivokuca ◽

B Goronja ◽

T Kovacevic ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Lung Ultrasound ◽

Ultrasound Guided ◽

Symptomatic Benefit

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Acute Bronchiolitis: Is There a Role for Lung Ultrasound?

Diagnostics ◽

10.3390/diagnostics9040172 ◽

2019 ◽

Vol 9 (4) ◽

pp. 172 ◽

Cited By ~ 4

Author(s):

Di Mauro ◽

Ammirabile ◽

Quercia ◽

Panza ◽

Capozza ◽

...

Keyword(s):

Clinical Management ◽

Lung Ultrasound ◽

Ultrasound Examination ◽

Diagnostic Algorithm ◽

Current Evidence ◽

Radiographic Examination ◽

First Year ◽

Pubmed Database ◽

First Year Of Life

Introduction: Viral bronchiolitis is a common cause of lower respiratory tract infection in the first year of life, considered a health burden because of its morbidity and costs. Its diagnosis is based on history and physical examination and the role of radiographic examination is limited to atypical cases. Thus far, Lung Ultrasound (LUS) is not considered in the diagnostic algorithm for bronchiolitis. Methods: PubMed database was searched for trials reporting on lung ultrasound examination and involving infants with a diagnosis of bronchiolitis. Results: Eight studies were suitable. Conclusions: This review analyzed the current evidence about the potential usefulness of LUS in the clinical management of bronchiolitis. Literature supports a peculiar role of LUS in the evaluation of the affected children, considering it as a reliable imaging test that could benefit the clinical management of bronchiolitis.

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Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

The Journal of Vascular Access ◽

10.1177/1129729820940174 ◽

2020 ◽

pp. 112972982094017

Author(s):

Giovanni Barone ◽

Mauro Pittiruti ◽

Gina Ancora ◽

Giovanni Vento ◽

Francesca Tota ◽

...

Keyword(s):

Intensive Care ◽

Critically Ill ◽

Neonatal Intensive Care ◽

Central Venous Access ◽

Venous Catheter ◽

Cephalic Vein ◽

Preterm Neonates ◽

Ultrasound Guided ◽

Central Venous ◽

Vein Catheterization

Objective: Central venous access in critically ill newborns can be challenging. Ultrasound-guided brachio-cephalic vein catheterization is a relatively new procedure, recently introduced in several neonatal intensive care units. The aim of this study is to evaluate the safety and feasibility of such a technique in preterm babies. Design: Retrospective analysis of prospectively collected data on ultrasound-guided central venous catheter insertion in preterm neonates. Setting: Neonatal intensive care unit. Patients: Critically ill preterm neonates with weight below 1500 g requiring a central access. Interventions: Ultrasound-guided brachio-cephalic vein catheterization. Main Results: Thirty centrally inserted catheters were placed in 30 neonates. The success rate of the procedure was 100%. No case of accidental arterial or pleural puncture was registered during the study period. Conclusion: The brachio-cephalic vein can be safely catheterized in preterm newborns requiring intensive care after appropriate training.

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