Lung Ultrasound: Role and Efficacy in Diagnosing and Follow-up of Patients with Neonatal Respiratory Distress Syndrome

Abstract
Background: Neonatal Respiratory Distress Syndrome (NRDS) or hyaline membrane disease result from surfactant deficiency with subsequent alveolar instability and collapse impeding the normal gas exchange. NRDS diagnosis is based primary on clinical findings, laboratory tests and chest radi-ography. Early diagnosis is crucial to start respiratory support and surfactant replacement.
Aim of Work: Evaluate the efficacy of Lung Ultrasound (LUS) in the diagnosis and follow-up of Neonatal Respiratory Distress Syndrome (NRDS) in the premature neonates.
Patients and Methods: Evaluation of 68 preterm neonates presented with respiratory distress and admitted in Neonatal Intensive Care Unit (NICU) was done. The gestational age ranged from 26 to 35 weeks (mean=30.24). The birth weight ranged from 800gm to 2.950kg (mean=1.429kg). Forty-one patients (60.3%) were males and 27 (39.7%) were females. All patients were subjected portable Chest X-Ray (CXR) within few hours of admission followed by bedside lung B-mode ultrasound within 24 hours. Follow-up CXR and ultra-sound were done on the 5th day to monitor response to treat-ment.
Results: Lung ultrasound was able to diagnose RDS in 68/68 patients on the first day. In comparison with the CXR, LUS had sensitivity, specificity, PPV and NPV of 100% in diagnosing RDS. On 5th day follow-up, LUS in comparison to CXR as regard detection of persistence or clearance of RDS had both specificity and PPV of 100% while sensitivity and NPV were 90% and 90.2% respectively.
Conclusion: LUS is safe and non-invasive technique and can be used as diagnostic tool in the diagnosis of RDS and following-up the effect of treatment thus reducing number of carried out X-ray.