Accuracy of lung ultrasonography in the diagnosis of respiratory distress syndrome in newborns

Objectives: Lung ultrasonography has become an important tool in the diagnosis and follow-up of lung diseases in the newborn period in recent years. Lung diseases such as pneumonia, transient tachypnea of the newborn and respiratory distress syndrome (RDS) can be diagnosed with lung ultrasound. Lung USG is a simple, practical and low-cost method in diagnosing neonatal RDS. Methods: This study was performed in Hacettepe University Neonatal Intensive Care Unit From December 2015 to February 2017. Forty patients who were diagnosed as RDS and given surfactant [200 mg/kg poractant alfa (CUROSURF (R), Chiesi, Italy) intratracheal Suspension] were included in the study. Lung ultrasonography was performed at the bedside by a single expert, once before surfactant treatment and three times after surfactant treatment. Post-treatment ultrasonographic examinations were carried out at 2, 4 and 6 h after surfactant treatment. Results: Before surfactant treatment, lung USG findings of patients were as follows: lung consolidation with air bronchograms (40/40), B-pattern (36/40), pleural line abnormalities (37/40), severe B-pattern (12/40) and disappearance of A-lines in all USG of patients. In the second hour of treatment, we did not see any valuable change or difference in lung USG findings of patients. The only change was the disappearance of air bronchograms and lung consolidation in five patients. Four hours after treatment we saw a reduction in lung consolidation in 14 patients, B-pattern had decreased in 15 patients, the appearance of A-lines and spared areas. But after 6 h, we started to see A-lines clearly, loss of B-pattern, an appearance of pleural line, and lung sliding in nearly all patients except three. Conclusion: Ultrasound is nonionizing and gives no hazard to the patient. Also, making it bedside is feasible and comfortable than other methods. Responsive and unresponsive patients to surfactant treatment can be determined in the early course of the disease and the cases needing re-treatment can be diagnosed easily by performing lung USG. This review focuses on ultrasonographic changes of the lung after surfactant treatment in premature newborns