Comparison between lung ultrasonography and chest X-ray in the evaluation of neonatal respiratory distress syndrome.

Abstract

Respiratory distress syndrome (RDS), also known as hyaline membrane disease, is the most common clinical syndrome encountered among preterm infants, and the complications of the disease account for substantial mortality. Diagnosis of RDS is based on the clinical status of patients in correlation with laboratory parameters and chest X-ray. Lung ultrasound despite its wide use still is not incorporated into diagnostic algorithms. The aim of the study was to evaluate the diagnostic ability of lung ultrasound in diagnosing respiratory distress syndrome as well as in the monitoring of the response to treatment. A secondary aim was to propose a modified ultrasound grading scale. The prospective study included 150 neonates with clinical and radiographic signs of neonatal respiratory distress syndrome within the first 24h of life, with different gestational age (≤ 35weeks). Lung ultrasound was performed by two radiologists and correlated with a chest X-ray. Two gradation scales (ultrasound and X-ray) were compared and each scale was correlated with the patient's clinical data. In comparison between ultrasound findings and X-ray results showed a statistically significant difference in a favor of ultrasound. Based on the presence of subpleural consolidations, further differentiation of ultrasound profiles were made into subgroups and new ultrasound classification have been proposed. Our study showed that lung ultrasound enables the diagnosing of respiratory distress syndrome in premature neonates and also shows a significant correlation with chest X-ray, which is considered as a radiological method of choice for the diagnosis of RDS.