Diagnostic Performance of Point of Care Ultrasonography in Identifying the Etiology of Respiratory Distress in Neonates

Abstract

To determine the diagnostic test performance of Point of care ultrasonography (PoC-USG) for identifying the etiology of respiratory distress (RD) in neonates when combination of radiological and clinical criteria is considered as the gold standard. A neonate was included in the study if he/she had RD and underwent x-ray chest and ultrasound within 4h of admission and the age was less than 24h. The neonates admitted with non-respiratory illness were chosen as controls. A trained neonatologist took trans-thoracic and trans-abdominal views and a radiologist, as per the defined criteria, did the interpretation. During the study period, 63 neonates with RD and 31 control neonates were enrolled. Overall from the clinical-radiological findings, the final diagnosis was respiratory distress syndrome (RDS), transient tachypnea of newborn (TTNB) and pneumonia in 29, 33 and one infants respectively. The ultrasound diagnosis of respiratory distress was RDS in 30 infants and TTNB in 33 infants. Pneumonia was not a diagnosis in any of the infants on PoC-USG. The sensitivity and specificity of USG in the diagnosis of respiratory distress were 98.4% and 100% respectively. One infant with diagnosis of pneumonia on chest x-ray was interpreted as RDS on USG. PoC-USG can be used to diagnose different etiologies of RD in neonates.