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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Lung ultrasound-a new diagnostic modality in persistent tachypnea of infancy
Emilia Urbankowska1, Tomasz Urbankowski2, Łukasz Drobczyński3
1Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.
Insights
Lung ultrasound (LUS) effectively identifies abnormalities in children with persistent tachypnea of infancy (PTI). This imaging technique shows promise for diagnosing PTI, potentially reducing the need for radiation-based procedures.
Area of Science:
- Pediatric Pulmonology
- Medical Imaging
- Diagnostic Ultrasound
Background:
- Lung ultrasound (LUS) is gaining traction for diagnosing and monitoring pediatric pulmonary conditions.
- Persistent tachypnea of infancy (PTI) is a condition requiring effective diagnostic tools.
- Evaluating LUS utility in pediatric PTI cases is crucial for clinical practice.
Purpose of the Study:
- To assess the diagnostic value of lung ultrasound (LUS) in children diagnosed with persistent tachypnea of infancy (PTI).
- To compare LUS findings in PTI patients with high-resolution computed tomography (HRCT) and healthy controls.
- To evaluate LUS findings over a 12-month follow-up period in children with PTI.
Main Methods:
- A controlled, prospective, cross-sectional study involving 20 children with PTI and healthy controls.
- Lung ultrasound (LUS) performed at baseline, 6, and 12 months for PTI patients.
- Comparison of LUS data with baseline HRCT images and control group LUS examinations.
Main Results:
- All children with PTI exhibited B-lines on LUS, compared to 55% of controls (P < .001).
- PTI patients showed significantly increased B-lines, pleural thickness, and pleural line irregularity versus controls.
- LUS findings in PTI patients remained consistent throughout the 12-month follow-up period.
- Significant correlations were observed between LUS parameters (B-lines, pleural thickness) and HRCT indices.
Conclusions:
- Lung ultrasound (LUS) demonstrates significant promise as a diagnostic tool for persistent tachypnea of infancy (PTI) in children.
- LUS findings in PTI patients are distinct and consistent, differentiating them from healthy subjects.
- Incorporating LUS into the diagnostic workup for PTI may reduce reliance on ionizing radiation-based imaging.
Abstract:
Lung ultrasound (LUS) has been increasingly used in diagnosing and monitoring of various pulmonary diseases in children. The aim of the current study was to evaluate its usefulness in children with persistent tachypnea of infancy (PTI). This was a controlled, prospective, cross-sectional study that included children with PTI and healthy subjects. In patients with PTI, LUS was performed at baseline and then after 6 and 12 months of follow-up. Baseline results of LUS were compared to (a) baseline high-resolution computed tomography (HRCT) images, (b) LUS examinations in control group, and (c) follow-up LUS examinations. Twenty children with PTI were enrolled. B-lines were found in all children with PTI and in 11 (55%) control subjects (P < .001). The total number of B-lines, the maximal number of B lines in any intercostal space, the distance between B-lines, and pleural thickness were significantly increased in children with PTI compared to controls. An irregularity of the pleural line was found in all patients with PTI and in none of the healthy children. There were no significant changes in LUS findings in patients with PTI during the study period. The comparison of HRCT indices and LUS findings revealed significant correlations between the mean lung attenuation, skewness, kurtosis and fraction of interstitial pulmonary involvement, and the number of B-lines as well as the pleural line thickness. LUS seems to be a promising diagnostic tool in children with PTI. Its inclusion in the diagnostic work-up may enable to reduce the number of costly, hazardous, and ionizing radiation-based imaging procedures.
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