Ultrasound scan for neonatal pulmonary diseases

Abstract

Objective To evaluate the value of sonography in diagnosis of neonatal pulmonary diseases and to provide a reliable and simple method for diagnosing neonatal pulmonary diseases.Methods From May 2012 to August 2012,105 newborns who admitted into Bayi Children's Hospital were enrolled into this study,including respiratory distress syndrome 40 cases (three of them with difficulty in withdrawing mechanical ventilation),meconium aspiration syndrome 17 cases,wet of newborn 17 cases and 30 health neonates without diseases.Lung ultrasound was performed at bedside by a single expert physician within the first 24 h of life.All patients with neonatal diseases were diagnosed by clinical manifestations,arterial blood gas analysis and chest X-ray.Results (1) Lung sonography of normal neonates showed hypo-echo (black),smooth and clear hyper-echoic pleural line.A line was hyper echo too.(2) All 40 neonates with respiratory distress syndrome showed consolidation with air bronchograms; abnormal pleural line,disappeared A-lines,pleural effusion and alveolar-interstitial syndrome.Five out of the 40 (12.5％)infants showed pleural effusion.(3) All 18 meconium aspiration syndrome infants showed focal consolidation under pleural membrane,alveolar-interstitial syndrome,atypical changes of abnormal pleural line and disappeared A-line in lesion area with sonography.(4) All infants with wet of newborn (100.0％,17/17) showed double point,with which all wet of newborn could be diagnosed.(5) Differential diagnosis of respiratory distress syndrome with wet of newborn:five infants with severe dyspnea showed white lung in X-ray and were diagnosed as respiratory distress syndrome,while sonography only showed severe edema and one infant showed pleural effusion which was in accordance with wet of newborn,so was their courses of disease.(6) Three cases of respiratory distress syndrome showed dyspnea after withdrawing mechanical ventilation,and sonography showed local atelectasis but normal in X-ray.Conclusions Lung ultrasound has many advantages,such as accurate,reliable,no radiation damage,low-cost and simple; therefore,it is feasible in neonatal ward. Key words: Respiratory distress syndrome, newborn; Meconium aspiration syndrome; Ultrasonography