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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Diagnosis of a Right Congenital Diaphragmatic Hernia in a Neonate with POCUS
Alyssa DaVolio1,2, Brandon S Hays1,3, Matthew O Thompson1,4
1Atrium Health Wake Forest Baptist, Brenner Children's Hospital, Winston-Salem, NC, USA.
Abstract:
Point of care ultrasound (POCUS) can be used to diagnose neonatal lung diseases, especially in the setting of a newborn with significant respiratory distress. A neonate was born at 38.4 weeks gestational age to a 36-year-old Gravida 5 Para 3013 woman with prenatal concerns for fetal cardiothoracic anomalies. Fetal echocardiogram demonstrated left atrial compression of unclear etiology. After delivery, the neonate experienced significant respiratory distress. A transthoracic echocardiogram revealed pulmonary hypertension but no structural heart disease. A lung POCUS exam revealed a homogenous echogenic structure within the right pleural cavity consistent with liver parenchyma. The initial diagnosis of right Congenital Diaphragmatic Hernia (CDH) was made and confirmed by a radiology-performed lung ultrasound and a computed tomography (CT) scan of the chest. This case demonstrated the utility of lung POCUS as an initial diagnostic tool in the neonatal intensive care unit (NICU) for CDH.
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