Objective To study the value of bedside lung ultrasound in the diagnosis of neonatal pneumonia. Methods A total of 49 neonates who were admitted to the Neonatal Intensive Care Unit of Chengdu Women and Children's Central Hospital in March 2017 with respiratory symptoms as the chief complaint were enrolled. Bedside lung ultrasound was performed within 24 hours after admission. A retrospective analysis was performed for their clinical data and lung ultrasound findings. The value of bedside lung ultrasound in the diagnosis of neonatal pneumonia was evaluated. Results According to the gold standard for the diagnosis of neonatal pneumonia, of all 49 neonates, 44 were diagnosed with pneumonia. According to the criteria for the diagnosis of neonatal pneumonia based on lung ultrasound findings, 38 neonates were diagnosed with pneumonia. In the neonates with respiratory symptoms, lung ultrasound had a sensitivity of 86%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 45% in the diagnosis of neonatal pneumonia. Among the 44 cases of neonatal pneumonia diagnosed by the gold standard, the lung ultrasonic images showed B-lines in all 44 neonates (100%), 75% had pleural line abnormalities, 36% had patchy or local hypoechoic area in the lung, 27% had alveolar-interstitial syndrome, and 20% had air bronchogram. Conclusions As a new diagnostic technique in clinical practice, bedside lung ultrasound has a high sensitivity and specificity for the diagnosis of neonatal pneumonia and can thus be used as a tool for the diagnosis of this disease.
Key words
Bedside lung ultrasound /
Pneumonia /
Diagnosis /
Neonate
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References
[1] Mathur NB, Garg K, Kumar S. Respiratory distress in neonates with special reference to pneumonia[J]. Indian Pediatr, 2002, 39(6):529-537.
[2] Bourcier JE, Paquet J, Seinger M, et al. Performance comparison of lung ultrasound and chest x-ray for the diagnosis of pneumonia in the ED[J]. Am J Emerg Med, 2014, 32(2):115-118.
[3] Liu J, Liu F, Wang HW, et al. Lung ultrasonography for the diagnosis of severe neonatal pneumonia[J]. Chest, 2014, 146(2):383-388.
[4] Vergine M, Copetti R, Brusa G, et al. Lung ultrasound accuracy in respiratory distress syndrome and transient tachypnea of the newborn[J]. Neonatology, 2014, 106(2):87-93.
[5] Brat R, Yousef N, Klifa R, et al. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure[J]. JAMA Pediatr, 2015, 169(8):e151797.
[6] 周晓玉. 感染性肺炎[M]//邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学. 第4版. 北京:人民卫生出版社, 2011:401-408.
[7] Pereda MA, Chavez MA, Hooper-Miele CC, et al. Lung ultrasound for the diagnosis of pneumonia in children:a meta-analysis[J]. Pediatrics, 2015, 135(4):714-722.
[8] Iorio G, Capasso M, De Luca G, et al. Lung ultrasound in the diagnosis of pneumonia in children:proposal for a new diagnostic algorithm[J]. Peer J, 2015, 3:e1374.
[9] Xirouchaki N, Georgopoulos D. The use of lung ultrasound:a brief review for critical care physicians and pneumonologists[J]. Pneumon, 2007, 20(2):134-141.
[10] Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound[J]. Intensive Care Med, 2012, 38(4):577-591.
[11] Jones BP, Tay ET, Elikashvili I, et al. Feasibility and safety of substituting lung ultrasonography for chest radiography when diagnosing pneumonia in children:a randomized controlled trial[J]. Chest, 2016, 150(1):131-138.
[12] Ye X, Xiao H, Chen B, et al. Accuracy of lung ultrasonography versus chest radiography for the diagnosis of adult community-acquired pneumonia:review of the literature and meta-analysis[J]. PLoS One, 2015, 10(6):e0130066.
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