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ORIGINAL ARTICLE
Il Giornale Italiano di Radiologia Medica 2018 Maggio-Giugno;5(3):341-7
DOI: 10.23736/S2283-8376.18.00045-1
Copyright © 2018 EDIZIONI MINERVA MEDICA
language: Italian
Use of neonatal chest US to predict noninvasive ventilation failure in the respiratory distress
Laura GABRIELI 1, Vito ALBEROTANZA 1 ✉, Federica LARICCHIA 1, Mariangela CARBONE 1, Antonio DI MAURO 2, Alberto GAETA 3
1 Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Bari Aldo Moro, Bari, Italia; 2 Unità Operativa di Pediatria e Neonatologia, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italia; 3 Unità Operativa di Radiodiagnostica, Ospedale Pediatrico Giovanni XXIII, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italia
BACKGROUND: This work on neonatal chest ultrasound has shown that the persistence of a hyperechogenic, “white lung” image correlates with severe distress in 28 infants. We investigate the persistent “white lung” ultrasound image in predicting the success or failure of noninvasive ventilation.
METHODS: Twenty-eight infants with mild to moderate respiratory distress (Silverman-Anderson score) were enrolled. After two hours, chest ultrasound and X-ray were performed. Based on the results, patients were classified as: type 1, with persistence of a hyperechogenic, white lung image correlates with severe distress in the preterm infant; type 2, with presence of multiple B lines; or type 3, with normal, with A lines and not B lines. Chest radiograph also was examined and graded by an experienced radiologist blind to the infants’ clinical conditions.
RESULTS: Twenty-eight patients were enrolled: 15 were classified as type 1, 13 as type 2 or 3. There were no significant differences in comparing the diagnostic accuracy between chest ultrasonography and chest X-ray.
CONCLUSIONS: Chest ultrasound is a fast and safe method for the diagnosis and follow-up of respiratory distress. Future studies should address whether including ultrasonography in the management of neonatal moderate respiratory distress confers clinical advantages.
KEY WORDS: Newborn respiratory distress syndrome - Infant - Ultrasonography - X-ray computed tomography - Noninvasive ventilation