Diagnostic ability of bedside lung Ultrasound in neonates with respiratory distress

Abstract

Respiratory distress accounts for almost 40% of admissions to Neonatal intensive care unit.1 The respiratory distress syndrome (RDS) and transient tachypnea of Newborn (TTN) are the most common cause of respiratory distress in the preterm and term neonates respectively.2 Chest X-rays are the cornerstone for the diagnosis of respiratory distress (RD). However, distinguishing RDS and TTN may be difficult during the first 24h after birth. Besides, x-rays are not safe for a newborn who is still undergoing maturation. Chest radiography is still the investigation of choice to evaluate the cause of RD in the neonates. However radiography findings are not always diagnostic, it has been shown to be inaccurate in many situations.3 In addition, chest X-ray itself has a wide intraand inter-observer variability and requires expensive equipment. The adverse effects of irradiation are higher among the Neonates and may be more pronounced in preterms.4 The potential weakness of bedside radiography is explainable by its principle: three dimensions are reduced to two. A CT scan could resolve many of these issues but involves transporting potentially unstable patients out of the department, larger radiation doses (typically 200 times that of a CXR), and the use of contrast makes it unsuitable for routine use in neonates. To circumvent these limitations, ultrasound lung may be a useful tool for the differential diagnosis of RD in newborns. The aim of this study was to determine the diagnostic accuracy of LUS in the evaluation of RDS and TTN in comparison to clinical and chest X ray diagnosis