The role of lung ultrasound in diagnosis of neonatal pneumonia / 中华医学超声杂志（电子版）

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 ifndings, the patients were classiifed 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 ifnal diagnosis of neonatal pneumonia was conifrmed 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.ConclusionLung 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.