The role of lung ultrasound in diagnosis of neonatal pneumonia

doi:10.3877/cma.j.issn.1672-6448.2016.12.005

Abstract

Abstract:

Objective

To evaluate the role of lung ultrasound in the diagnosis of neonatal pneumonia.

Methods

From April to October 2015, 100 neonates admitted to the Neonatal Department of Xi′an Children′s Hospital underwent lung ultrasound, using the 12 regions method. All intercostal spaces of the upper and lower parts of the anterior, lateral, and posterior regions of the left and right lung were examined. Arterial blood gas analysis parameters of each case were recorded at the same time, including arterial partial pressure of oxygen (PO₂), arterial partial pressure of carbon dioxide (PCO₂), pH value and oxygen saturation (SO₂). A skilled sonographer analyzed the ultrasound images before being aware of the patient′s clinical condition. According to the findings, the patients were classified into 2 groups: neonatal pneumonia group and non-pneumonia group. All the patients with neonatal pneumonia underwent lung ultrasound score (LUS), and the correlation between LUS and PO₂, PCO₂, pH value and SO₂ was analyzed.

Results

A final diagnosis of neonatal pneumonia was confirmed in 62/100 patients. The ultrasonographic manifestations of neonatal pneumonia were as follows: rocket sign (33/62 patients, 53%), ground-glass sign (35/62 patients, 56%) , waterfall sign (31/62 patients, 50%), white lung (8/62 patients, 13%), subpleural lung consolidation (35/62 patients, 56%), pleural line abnormalities (26/62 patients, 41%), pleural effusion (7/62 patients, 11%), atelectasis (3/62 patients, 4%) , and pneumothorax (1/62 patients, 1%). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of lung ultrasound in the diagnosis of neonatal pneumonia was 96.77%, 86.84%, 93.00% of 92.30%, of 94.28%, respectively. The correlation coefficients between LUS and PO₂, PCO₂, pH value, SO₂ were -0.82, 0.64, -0.58, -0.74, P<0.05, respectively.

Conclusion

Lung ultrasound is a reliable tool for diagnosing neonatal pneumonia with high sensitivity, with high practical value in assisting clinicians to carry out appropriate treatment in combination with LUS.

Key words: Lung, Ultrasonography, Pneumonia, Infant, newborn

Fang Liu, Jinzhuo Yue, Bailing Liu, Ting Wang. The role of lung ultrasound in diagnosis of neonatal pneumonia[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(12): 898-903.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.12.005

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References 18

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组别	例数	年龄（d）	体重（kg）	出生胎龄（周）	呼吸频率（次/分）	收缩压（mmHg）	舒张压（mmHg）	胸膜厚度（mm）
肺炎组	38	11.4±10.7	3.2±0.7	38.5±2.5	51.8±7.5	71.8±9.1	41.7±6.5	0.8±0.3
对照组	62	9.5±7.0	3.1±0.4	39.0±1.4	45.4±2.8	74.1±5.3	43.8±6.1	0.5±0.2
t值	?	1.62	0.78	0.88	3.11	1.37	0.17	2.89
P值	?	>0.05	>0.05	>0.05	<0.001	>0.05	>0.05	<0.001

组别	例数	年龄（d）	体重（kg）	出生胎龄（周）	呼吸频率（次/分）	收缩压（mmHg）	舒张压（mmHg）	胸膜厚度（mm）
肺炎组	38	11.4±10.7	3.2±0.7	38.5±2.5	51.8±7.5	71.8±9.1	41.7±6.5	0.8±0.3
对照组	62	9.5±7.0	3.1±0.4	39.0±1.4	45.4±2.8	74.1±5.3	43.8±6.1	0.5±0.2
t值	?	1.62	0.78	0.88	3.11	1.37	0.17	2.89
P值	?	>0.05	>0.05	>0.05	<0.001	>0.05	>0.05	<0.001

肺部超声检查	临床诊断		合计
肺部超声检查	肺炎	无肺炎	合计
肺炎	60	5	65
无肺炎	2	33	35
合计	62	38	100

肺部超声检查	临床诊断		合计
肺部超声检查	肺炎	无肺炎	合计
肺炎	60	5	65
无肺炎	2	33	35
合计	62	38	100

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