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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
06:15

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Published on: March 6, 2019

Persistent pulmonary abnormalities in newborns: the changing picture of bronchopulmonary dysplasia

M A Heneghan, R Sosulski, J M Baquero

    Pediatric Radiology
    |January 1, 1986
    PubMed

    Insights

    Recent advances in neonatal respiratory distress syndrome (RDS) treatment have altered bronchopulmonary dysplasia (BPD) radiographic features. Many infants with BPD show atypical findings, complicating diagnosis and highlighting the need for updated imaging criteria.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Radiology
    • Pulmonology

    Background:

    • Advances in neonatal respiratory distress syndrome (RDS) treatment have coincided with changes in bronchopulmonary dysplasia (BPD) radiographic features.
    • Traditional BPD staging may not fully capture the spectrum of lung disease in neonates receiving modern care.

    Purpose of the Study:

    • To evaluate current radiographic findings in neonates with clinical bronchopulmonary dysplasia (BPD).
    • To assess the correlation between radiographic patterns and clinical severity of chronic lung disease.
    • To differentiate atypical BPD presentations from other neonatal lung conditions.

    Main Methods:

    • Retrospective analysis of radiographic features in 709 newborns.
    • Comparison of imaging findings with clinical BPD diagnosis and severity.
    • Evaluation of specific radiographic patterns, including infiltrates and emphysema, in relation to respiratory support.

    Main Results:

    • Atypical radiographic findings were observed in 40% of infants with clinical BPD and significant respiratory dysfunction.
    • Radiographic progression through all BPD stages was uncommon.
    • Diagnosis of BPD stages was complicated by conditions like patent ductus arteriosus (PDA) and pulmonary interstitial emphysema (PIE).
    • Mild infiltrates (type 1) may represent delayed RDS resolution or mild BPD, while coarse infiltrates/emphysema (type 2) indicate severe disease.

    Conclusions:

    • Bronchopulmonary dysplasia (BPD) exhibits diverse radiographic presentations in neonates treated for respiratory distress syndrome (RDS).
    • Clinical severity correlates with radiographic findings, but atypical patterns necessitate careful interpretation.
    • Distinguishing between delayed RDS resolution, immature lung, and mild BPD based on imaging requires consideration of clinical context and oxygen dependence.

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