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Neonatology. 2019 Feb 7;115(3):263-268. doi: 10.1159/000495911. [Epub ahead of print]

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate.

Author information

1
Division of Neonatology, Department of Translational Medical Sciences, Università "Federico II", Naples, Italyraimondi@unina.it.
2
Division of Pediatrics and Neonatal Critical Care, Medical Centre "A. Béclère", South Paris University Hospitals, APHP, Paris, France.
3
Hospital "San Juan de Diòs", Barcelona, Spain.
4
Physiopathology and Therapeutic Innovation U999, South Paris-Saclay University, Paris, France.
5
Università di Firenze, Florence, Italy.
6
Ospedale Cannizzaro, Catania, Italy.
7
Università di Milano, Milan, Italy.
8
Division of Neonatology, Department of Translational Medical Sciences, Università "Federico II", Naples, Italy.
9
Pediatric Radiology, Department of Advanced Biomedical Sciences, Università "Federico II", Naples, Italy.

Abstract

BACKGROUND AND AIM:

Discordant results that demand clarification have been published on diagnostic lung ultrasound (LUS) signs of transient tachypnea of the neonate (TTN) in previous cross-sectional, single-center studies. This work was conducted to correlate clinical and imaging data in a longitudinal and multicenter fashion.

METHODS:

Neonates with a gestational age of 34-40 weeks and presenting with TTN underwent a first LUS scan at 60-180 min of life. LUS scans were repeated every 6-12 h if signs of respiratory distress persisted. Images were qualitatively described and a LUS aeration score was calculated. Clinical data were collected during respiratory distress.

RESULTS:

We enrolled 65 TTN patients. Thirty-one (47.6%) had a sharp echogenicity increase in the lower lung fields (the "double lung point" or DLP sign). On admission, there was no significant difference between patients with and without DLP in Silverman scores (4 ± 1.5 vs. 4 ± 2.1; p = 0.9) or LUS scores (7.6 ± 2.6 vs. 5.6 ± 3.8; p = 0.12); PaO2/FiO2 (249 ± 93 vs. 252 ± 125; p = 0.91). All initial LUS scans (performed at the onset of distress) and 99.5% of all scans showed a regular pleural line with no consolidation, with only 1 neonate showing consolidation in the follow-up scans. The Silverman and LUS scores were significantly correlated (rho = 0.27; p = 0.02).

CONCLUSION:

A regular pleural line with no consolidation is a consistent finding in TTN. The presence of a DLP is not essential for the LUS diagnosis of TTN. A semi-quantitative LUS score correlates well with the clinical course and could be useful in monitoring changes in lung aeration during TTN.

KEYWORDS:

Lung; Neonate; Transient tachypnea of the neonate; Ultrasound

PMID:
30731475
DOI:
10.1159/000495911

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