Lung Ultrasound in the Evaluation of Neonatal Respiratory Distress Syndrome
Xin Hua, Lijun Wang, Hao Wei, Haiyang Hu, Hecui Li, Bin Liu
Abstract
OBJECTIVE: The purpose of this study is to examine the impact of bedside lung ultrasound (LUS) and LUS scores in the evaluating and grading of neonatal respiratory distress syndrome (NRDS). METHODS: ratio of <200, 200-300, and >300 mmHg were categorized as the "severe-NRDS group," "mild-NRDS group," and "non-NRDS group," respectively. Left and right lungs were divided into six areas, respectively. For each lung area, a 0- to 3-point score was given. RESULTS: The most common ultrasonic signs of NRDS include bilateral coalescent B-lines, thickened pleural line, and white lung without spared areas. Moreover, different LUS scores among non-NRDS, mild-NRDS, and severe-NRDS groups were identified (6.00 ± 4.033, 25.82 ± 3.778 and 27.90 ± 4.071, respectively; P < .05). When the cutoff value of LUS score was selected as 13 for the differentiation of non-NRDS from NRDS, the sensitivity and specificity were 96.9% and 93.3%, respectively, and the area under the curve (AUC) of receiver operating characteristics (ROC) was 0.938 (95% confidence interval [CI], 0.84-1.00). With a cutoff value of 26.5 for the differentiation between mild- and severe-ARDS, the AUC of ROC curve of the LUS score was 0.707 (95% CI, 0.58-0.83). Similar results were revealed as those with chest X-ray. CONCLUSION: This study showed that LUS and LUS scores complement each other, and are highly reliable and efficient in bedside radiological diagnostic investigations in newborns with NRDS.