Double Doppler Tei index combined with lung ultrasound to evaluate the right ventricular function and lung condition in neonates with pulmonary hypertension.

Abstract

To explore the applicability of the Tei index combined with lung ultrasound score (LUS) in the evaluation of the lung condition and the right ventricular function of patients with neonatal pulmonary hypertension (PH). Thirty healthy neonates and 75 neonates with PH were included. Two-dimensional, M-mode, and double Doppler ultrasound were used to detect RVFAC, TAPSE, TAPSV, and double Doppler Tei index (DD-Tei index). Intra-group correlation coefficient (ICC), Bland-Altman, the Spearman rank method, and the ROC (receiver operating characteristic) were used for other objectives within the study. LUS was used to score the lung condition of 75 neonates with PH with or without respiratory distress and 30 normal neonates in the control group, and the differences were compared. Spearman rank correlation was used to analyze the lung score, DD-Tei index, pulmonary artery pressure, assisted breathing therapy, and the correlation of invasive mechanical ventilation. There were statistically significant differences in the decrease of the values of RVFAC, TAPSE, TAPSV, and the increase of the DD-Tei index among the groups. RVFAC, TAPSE, TAPSV, and DD-Tei index showed good performance for PH, and the DD-Tei index had the best diagnostic performance. The increase in pulmonary artery pressure, lung score, and DD-Tei index in the PH were statistically significant compared with the control group. The DD-Tei index and lung scores were positively correlated with pulmonary artery pressure, assisted breathing therapy, and invasive mechanical ventilation. Dual Doppler ultrasonography combined with pulmonary ultrasound performed well in the assessment of the right ventricular function and lung condition of neonatal with PH.