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Pediatric chest imaging
1Children's Hospital of Los Angeles, California.
Insights
New therapies improve outcomes for neonates with respiratory distress syndrome. However, extracorporeal membrane oxygenation for diaphragmatic hernia may lead to long-term pulmonary and neurologic issues. Ultrasonography shows new diagnostic uses.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Medical Imaging
Background:
- Respiratory distress syndrome (RDS) and related neonatal disorders have significant morbidity and mortality rates.
- Exogenous surfactant therapy has improved outcomes for infants with surfactant deficiency.
- Extracorporeal membrane oxygenation (ECMO) is used for severe conditions like congenital diaphragmatic hernia (CDH).
Purpose of the Study:
- To review recent advancements in neonatal respiratory therapies.
- To evaluate long-term outcomes for neonates treated with ECMO for CDH.
- To explore novel applications of ultrasonography in pediatric diagnostics.
Main Methods:
- Literature review of recent therapeutic interventions for neonatal respiratory disorders.
- Analysis of follow-up data from patients treated with ECMO for CDH.
- Description of emerging ultrasonography techniques for airway and neck evaluations.
Main Results:
- Exogenous surfactant therapy has markedly improved survival rates in neonates with RDS.
- Follow-up studies indicate persistent pulmonary and neurologic abnormalities in infants treated with ECMO for CDH.
- Ultrasonography is effective for evaluating retropharyngeal/parapharyngeal infections and perithyroidal inflammation.
Conclusions:
- Current therapies offer significant benefits for neonatal respiratory distress.
- Long-term surveillance is crucial for neonates treated with ECMO due to potential chronic complications.
- Ultrasonography presents a valuable, non-invasive tool for diagnosing specific pediatric neck and airway conditions.
Abstract:
Several new therapies have resulted in marked improvement in morbidity and mortality rates for neonates with respiratory distress syndrome and related disorders. These therapies include the use of exogenous surfactant to treat existing surfactant deficiency in babies with respiratory distress syndrome. Follow-up of patients previously treated with extracorporeal membrane oxygenation for diaphragmatic hernia has shown continued pulmonary function abnormalities despite this therapy. Follow-up studies have also shown significant neurologic abnormalities. New uses of ultrasonography include scanning of the larynx and airway for evaluating retropharyngeal and parapharyngeal infections and evaluating perithyroidal inflammation secondary to congenital fistulas in this region.