Lung ultrasound features predict admission to the neonatal intensive care unit in infants with transient neonatal tachypnoea or respiratory distress syndrome born by caesarean section.
Caesarean section
Lung ultrasound
Neonatal intensive care unit
Newborn
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
24
06
2020
accepted:
20
08
2020
revised:
17
08
2020
pubmed:
20
9
2020
medline:
24
6
2021
entrez:
19
9
2020
Statut:
ppublish
Résumé
We aimed to evaluate the reliability of lung ultrasound (LU) to predict admission to the neonatal intensive care unit (NICU) for transient neonatal tachypnoea or respiratory distress syndrome in infants born by caesarean section (CS). A prospective, observational, single-centre study was performed in the delivery room and NICU of Sant'Orsola-Malpighi Hospital in Bologna, Italy. Term and late-preterm infants born by CS were included. LU was performed at 30' and 4 h after birth. LU appearance was graded according to a previously validated three-point scoring system (3P-LUS: type-1, white lung; type-2, black/white lung; type-3, normal lung). Full LUS was also calculated. One hundred infants were enrolled, and seven were admitted to the NICU. The 5 infants with bilateral type-1 lung at birth were all admitted to the NICU. Infants with type-2 and/or type-3 lung were unlikely to be admitted to the NICU. Mean full-LUS was 17 in infants admitted to the NICU, and 8 in infants not admitted. In two separate binary logistic regression models, both the 3P- and the full LUS proved to be independently associated with NICU admission (OR [95% CI] 0.001 [0.000-0.058], P = .001, and 2.890 [1.472-5.672], P = .002, respectively). The ROC analysis for the 3P-LUS yielded an AUC of 0.942 (95%CI, 0.876-0.979; P<.001), while ROC analysis for the full LUS yielded an AUC of 0.978 (95%CI, 0.926-0.997; P<.001). The AUCs for the two LU scores were not significantly different (p = .261).Conclusion: the 3P-LUS performed 30 min after birth proved to be a reliable tool to identify, among term and late preterm infants born to CS, those who will require NICU admission for transient neonatal tachypnoea or respiratory distress syndrome. What is known • Lung ultrasound (LU) has become an attractive diagnostic tool in neonatal settings, and guidelines on point-of-care LU in the neonatal intensive care unit (NICU) have been recently issued. • LU is currently used for diagnosing several neonatal respiratory morbidities and has been also proposed for predicting further intervention, such as NICU admission, need for surfactant treatment or mechanical ventilation in preterm infants. What is new • LU performed 30' after birth and evaluated through a simple three-point scoring system represents a reliable tool to identify, among term and late preterm infants born to caesarean section, those with transient neonatal tachypnoea or respiratory distress syndrome who will require NICU admission. • LU performed in the neonatal period confirms its potential role in ameliorating routine neonatal clinical management.
Identifiants
pubmed: 32949291
doi: 10.1007/s00431-020-03789-z
pii: 10.1007/s00431-020-03789-z
pmc: PMC7886822
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
869-876Références
Baumfeld Y, Walfisch A, Wainstock T, Segal I, Sergienko R, Landau D, Sheiner E (2018) Elective cesarean delivery at term and the long-term risk for respiratory morbidity of the offspring. Eur J Pediatr 177:1653–1659. https://doi.org/10.1007/s00431-018-3225-8
doi: 10.1007/s00431-018-3225-8
pubmed: 30091110
Tollånes MC, Moster D, Daltveit AK, Irgens LM (2008) Cesarean section and risk of severe childhood asthma: a population-based cohort study. J Pediatr 153:112–117. https://doi.org/10.1016/j.jpeds.2008.01.029
doi: 10.1016/j.jpeds.2008.01.029
pubmed: 18571547
Jain L, Eaton DC (2006) Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol 30:34–43. https://doi.org/10.1053/j.semperi.2006.01.006
doi: 10.1053/j.semperi.2006.01.006
pubmed: 16549212
Blank DA, Omar Farouk Kamlin C, Rogerson SR et al (2018) Lung ultrasound immediately after birth to describe normal neonatal transition: an observational study. Arch Dis Child Fetal Neonatal Ed 103:F157–F162. https://doi.org/10.1136/archdischild-2017-312818
doi: 10.1136/archdischild-2017-312818
pubmed: 28659360
Corsini I, Parri N, Gozzini E, Coviello C, Leonardi V, Poggi C, Giacalone M, Bianconi T, Tofani L, Raimondi F, Dani C (2019) Lung ultrasound for the differential diagnosis of respiratory distress in neonates. Neonatology 115:77–84. https://doi.org/10.1159/000493001
doi: 10.1159/000493001
pubmed: 30304736
De Luca D (2020) Semiquantititative lung ultrasound scores are accurate and useful in critical care, irrespective of patients’ ages: the power of data over opinions. J Ultrasound Med 39:1235–1239. https://doi.org/10.1002/jum.15195
doi: 10.1002/jum.15195
pubmed: 31840856
Woods PL (2019) Utility of lung ultrasound scanning in neonatology. Arch Dis Child 104:909–915. https://doi.org/10.1136/archdischild-2017-314538
doi: 10.1136/archdischild-2017-314538
pubmed: 30413490
Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J, Sanchez-de-Toledo J, Brierley J, Colunga JM, Raffaj D, da Cruz E, Durand P, Kenderessy P, Lang HJ, Nishisaki A, Kneyber MC, Tissieres P, Conlon TW, de Luca D (2020) International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care 24:1–16. https://doi.org/10.1186/s13054-020-2787-9
doi: 10.1186/s13054-020-2787-9
Raimondi F, Migliaro F, Sodano A, Umbaldo A, Romano A, Vallone G, Capasso L (2012) Can neonatal lung ultrasound monitor fluid clearance and predict the need of respiratory support? Crit Care 16:R220. https://doi.org/10.1186/cc11865
doi: 10.1186/cc11865
pubmed: 23151314
pmcid: 3672599
De Martino L, Yousef N, Ben-Ammar R et al (2018) Lung ultrasound score predicts surfactant need in extremely preterm neonates. Pediatrics 142:e20180463. https://doi.org/10.1542/peds.2018-0463
doi: 10.1542/peds.2018-0463
pubmed: 30108142
Razak A, Faden M (2020) Neonatal lung ultrasonography to evaluate need for surfactant or mechanical ventilation: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 105:164–171. https://doi.org/10.1136/archdischild-2019-316832
doi: 10.1136/archdischild-2019-316832
pubmed: 31248960
Volpicelli G, Elbarbary M, Blaivas M et al (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577–591. https://doi.org/10.1007/s00134-012-2513-4
doi: 10.1007/s00134-012-2513-4
pubmed: 22392031
Kurepa D, Zaghloul N, Watkins L, Liu J (2018) Neonatal lung ultrasound exam guidelines. J Perinatol 38:11–22. https://doi.org/10.1038/jp.2017.140
doi: 10.1038/jp.2017.140
pubmed: 29144490
Evans N, Gournay V, Cabanas F, Kluckow M, Leone T, Groves A, McNamara P, Mertens L (2011) Point-of-care ultrasound in the neonatal intensive care unit: international perspectives. Semin Fetal Neonatal Med 16:61–68. https://doi.org/10.1016/j.siny.2010.06.005
doi: 10.1016/j.siny.2010.06.005
pubmed: 20663724
Edwards MO, Kotecha SJ, Kotecha S (2013) Respiratory distress of the term newborn infant. Paediatr Respir Rev 14:29–37. https://doi.org/10.1016/j.prrv.2012.02.002
doi: 10.1016/j.prrv.2012.02.002
pubmed: 23347658
Avery ME, Gatewood OB, Brumley G (1966) Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am J Dis Child 111:380–385. https://doi.org/10.1001/archpedi.1966.02090070078010
doi: 10.1001/archpedi.1966.02090070078010
pubmed: 5906048
Raimondi F, Migliaro F, Sodano A, Ferrara T, Lama S, Vallone G, Capasso L (2014) Use of neonatal chest ultrasound to predict noninvasive ventilation failure. Pediatrics 134:e1089–e1094. https://doi.org/10.1542/peds.2013-3924
doi: 10.1542/peds.2013-3924
pubmed: 25180278
Brat R, Yousef N, Klifa R, Reynaud S, Shankar Aguilera S, de Luca D (2015) Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr 169:1–8. https://doi.org/10.1001/jamapediatrics.2015.1797
doi: 10.1001/jamapediatrics.2015.1797
De Luca D, van Kaam AH, Tingay DG et al (2017) The Montreux definition of neonatal ARDS: biological and clinical background behind the description of a new entity. Lancet Respir Med 5:657–666
doi: 10.1016/S2213-2600(17)30214-X
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845
doi: 10.2307/2531595
Martelius L, Janér C, Süvari L, Helve O, Lauerma K, Pitkänen O, Andersson S (2013) Delayed lung liquid absorption after cesarean section at term. Neonatology 104:133–136. https://doi.org/10.1159/000351290
doi: 10.1159/000351290
pubmed: 23887625
Blank DA, Rogerson SR, Kamlin COF, Fox LM, Lorenz L, Kane SC, Polglase GR, Hooper SB, Davis PG (2017) Lung ultrasound during the initiation of breathing in healthy term and late preterm infants immediately after birth, a prospective, observational study. Resuscitation 114:59–65. https://doi.org/10.1016/j.resuscitation.2017.02.017
doi: 10.1016/j.resuscitation.2017.02.017
pubmed: 28249708
Raimondi F, Yousef N, Rodriguez Fanjul J, de Luca D, Corsini I, Shankar-Aguilera S, Dani C, di Guardo V, Lama S, Mosca F, Migliaro F, Sodano A, Vallone G, Capasso L (2019) A multicenter lung ultrasound study on transient tachypnea of the neonate. Neonatology 115:263–268. https://doi.org/10.1159/000495911
doi: 10.1159/000495911
pubmed: 30731475
Blank DA, Gaertner VD, Kamlin COF, Nyland K, Eckard NO, Dawson JA, Kane SC, Polglase GR, Hooper SB, Davis PG (2018) Respiratory changes in term infants immediately after birth. Resuscitation 130:105–110. https://doi.org/10.1016/j.resuscitation.2018.07.008
doi: 10.1016/j.resuscitation.2018.07.008
pubmed: 30003934
Martelius L, Süvari L, Janér C, Helve O, Kaskinen A, Kirjavainen T, Pitkänen O, Andersson S (2015) Lung ultrasound and static lung compliance during postnatal adaptation in healthy term infants. Neonatology 108:287–292. https://doi.org/10.1159/000438453
doi: 10.1159/000438453
pubmed: 26345316
Corsini I, Parri N, Dani C (2020) Point-of-care lung ultrasound in neonatology: ready or not, here it comes! Chest 157:759–760. https://doi.org/10.1016/j.chest.2020.01.007
doi: 10.1016/j.chest.2020.01.007
pubmed: 32252923
Gomond-Le Goff C, Vivalda L, Foligno S et al (2020) Effect of different probes and expertise on the interpretation reliability of point-of-care lung ultrasound. Chest 157:924–931. https://doi.org/10.1016/j.chest.2019.11.013
doi: 10.1016/j.chest.2019.11.013
pubmed: 31785252
Mazmanyan P, Kerobyan V, Shankar-Aguilera S, Yousef N, de Luca D (2020) Introduction of point-of-care neonatal lung ultrasound in a developing country. Eur J Pediatr 179:1131–1137. https://doi.org/10.1007/s00431-020-03603-w
doi: 10.1007/s00431-020-03603-w
pubmed: 32060800
Raimondi F, Yousef N, Migliaro F, Capasso L, de Luca D (2018) Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications. Pediatr Res 20:1–8. https://doi.org/10.1038/s41390-018-0114-9
doi: 10.1038/s41390-018-0114-9
Rodríguez-Fanjul J, Llop AS, Balaguer M, Bautista-Rodriguez C, Hernando JM, Jordan I (2016) Usefulness of lung ultrasound in neonatal congenital heart disease (LUSNEHDI): lung ultrasound to assess pulmonary overflow in neonatal congenital heart disease. Pediatr Cardiol 37:1482–1487. https://doi.org/10.1007/s00246-016-1461-0
doi: 10.1007/s00246-016-1461-0
pubmed: 27623867
Raimondi F, Migliaro F, Verdoliva L, Gragnaniello D, Poggi G, Kosova R, Sansone C, Vallone G, Capasso L (2018) Visual assessment versus computer-assisted gray scale analysis in the ultrasound evaluation of neonatal respiratory status. PLoS One 13:e0202397. https://doi.org/10.1371/journal.pone.0202397
doi: 10.1371/journal.pone.0202397
pubmed: 30335753
pmcid: 6193620
Fraga MV, Stoller JZ, Lorch SA (2018) Novel technologies for neonatal care: the case of point-of-care lung ultrasonography. Pediatrics 142:e20181621. https://doi.org/10.1542/peds.2018-1621
doi: 10.1542/peds.2018-1621
pubmed: 30108143