Role of Lung Ultrasound in the Diagnosis of Neonatal Respiratory Disorders

Abstract

Abstract lung ultrasound (LUS) was used traditionally in the assessment of pleural effusions and masses but LUS has moved towards the imaging of the pulmonary parenchyma, mainly as a point-of-care technique. Objective To assess the agreement between LUS and CXR for the diagnosis of RD in neonates. Methods This prospective cross sectional study was conducted on 100 neonates presents with RD in the first 24 hours of life in the neonatal intensive care unit (NICU) of the Ain Shams University. All enrolled neonates underwent LUS and CXR initially and on day 7. Neonatologists were blind to the LUS diagnosis and the clinical decisions were driven by CXR findings. Lung score was applied to describe lung aeration, interstitial, alveolar, or consolidation patterns for each lung area. Results 125 different diagnoses were reported in 100 patients. The total agreement between LUS and CXR diagnosis was 96% (95% CI 88–98%) with a κ statistic of 0.94 (95% CI 0.86– 1.00). The agreement for RDS, Pneumonia, TTN, MAS, CDH, PE, Pnumothorax and atelectasis were 99%, 96%,98%, 99%,100%,100%,98% and 98% consequently. Conclusion LUS is a safe, low coast, easy to operate and has high agreement with CXR for the diagnosis of RD in neonates in the first week of life. Key words Neonatal intensive care, Point-of-care ultrasound, Chest X-ray Abbreviations: NICU: Neonatal Intensive Care Unit, LUS: Lung ultrasound, CXR: Chest X ray, RDS: respiratory distress syndrome, TTN: Transient Tachypnea of Newborn, MAS: Meconium Aspiration, PE: pleural effusion, CDH: cong. diaphragmatic hernia.