G206(P)\u2005Neonatal lung ultrasound in respiratory distress: a case series

Abstract

Introduction and objective Respiratory distress in neonates has a wide spectrum of aetiology, ranging from transient tachypnoea of the new-born, to surfactant deficiency which may require mechanical ventilation. It is diagnosed using clinical parameters such as tachypnoea and oxygen requirement and imaging using chest x-ray (CXR). Previous studies have shown that neonatal lung ultrasound complements the clinical assessment, and can predict the need of surfactant administration. The aim of this study was to compare lung ultrasound and chest x-ray and relate the imaging findings to the clinical outcome. Method 5 neonates with respiratory distress underwent lung ultrasound and chest x-ray. Each lung was scanned in 3 separate areas and scores were assigned to these areas based on the lung ultrasound score (LUS). Their clinical course in the neonatal unit was documented and LUS was compared to the CXR report. Results All 5 neonates were shown to have respiratory distress with no focal pathology on the CXR and ultrasound. Those with a lower LUS needed fewer days or no time on non-invasive ventilation, and those with higher scores needed greater time on non-invasive or mechanical ventilation. One patient who had a high LUS but a normal report of CXR, deteriorated after imaging and required surfactant administration and mechanical ventilation. Conclusion In line with the literature, we have shown that lung ultrasound can be used as part of the initial assessment of an infant with respiratory distress; it can aid the decision-making process regarding the need for escalation in respiratory support. The lack of exposure to radiation and ease as a bedside tool for neonatologists, gives lung ultrasound a clear advantage over CXR.