Point-of-care chest ultrasound in the Neonatal Intensive Care Unit

Chest ultrasound is a useful diagnostic tool in adult emergency medicine. Echography does not generate a clear image of the lung but is able to generate artifacts that are combined in disease-specific profiles. Reflections of the pleural image appear as short straight lines also known as A-lines. Ve...

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Main Authors: Francesco Raimondi, Fiorella Migliaro, Angela Sodano, Gianfranco Vallone, Teresa Ferrara, Sergio Maddaluno, Clara Coppola, Letizia Capasso
Format: Article
Language:English
Published: Hygeia Press di Corridori Marinella 2013-08-01
Series:Journal of Pediatric and Neonatal Individualized Medicine
Subjects:
Online Access:https://www.jpnim.com/index.php/jpnim/article/view/83
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author Francesco Raimondi
Fiorella Migliaro
Angela Sodano
Gianfranco Vallone
Teresa Ferrara
Sergio Maddaluno
Clara Coppola
Letizia Capasso
author_facet Francesco Raimondi
Fiorella Migliaro
Angela Sodano
Gianfranco Vallone
Teresa Ferrara
Sergio Maddaluno
Clara Coppola
Letizia Capasso
author_sort Francesco Raimondi
collection DOAJ
description Chest ultrasound is a useful diagnostic tool in adult emergency medicine. Echography does not generate a clear image of the lung but is able to generate artifacts that are combined in disease-specific profiles. Reflections of the pleural image appear as short straight lines also known as A-lines. Vertical, comet-tail artifacts departing from the pleura are named B-lines. The former are present in the normal lung while the latter have been described in the adult wet lung. Lung ultrasonography outperforms conventional radiology in the emergency diagnosis of pneumothorax and pleural effusions. Neonatologists and pediatricians are now adapting lung ultrasound to their specific clinical issues. The normal image is relatively unchanged throughout the age span, while progressively fading B-lines describe the fluid-to-air transition of the neonatal lung. Also, an homogeneous white (hyperechogenic) lung with pleural image abnormalities and absence of spared areas is accurate in diagnosing Respiratory Distress Syndrome (RDS). The prevalence of A-lines in the upper lung fields with B-lines at the bottom fields (aka double lung point artifact) is highly sensitive and specific in describing Transient Tachypnea of the Newborn. Infantile pneumonia has recently been proved an accurate diagnosis by ultrasound after a short training. In summary, chest ultrasonography has no ground to replace conventional chest radiology tout court. However, when appropriately applied, a lung ultrasound scan can save time and radiation exposure to achieve a critical diagnosis.   Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy) · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research
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spelling doaj.art-ee5cc63a21f6474f8137ae80e83da9622022-12-22T03:39:47ZengHygeia Press di Corridori MarinellaJournal of Pediatric and Neonatal Individualized Medicine2281-06922013-08-0122e020214e02021410.7363/02021461Point-of-care chest ultrasound in the Neonatal Intensive Care UnitFrancesco Raimondi0Fiorella Migliaro1Angela Sodano2Gianfranco Vallone3Teresa Ferrara4Sergio Maddaluno5Clara Coppola6Letizia Capasso7Department of Translational Medical Sciences, Section of Pediatrics, “Federico II” University, NaplesDepartment of Translational Medical Sciences, Section of Pediatrics, “Federico II” University, NaplesDepartment of Translational Medical Sciences, Section of Pediatrics, “Federico II” University, NaplesDepartment of Radiology, “Federico II” University, NaplesDepartment of Translational Medical Sciences, Section of Pediatrics, “Federico II” University, NaplesDepartment of Translational Medical Sciences, Section of Pediatrics, “Federico II” University, NaplesDepartment of Translational Medical Sciences, Section of Pediatrics, “Federico II” University, NaplesDepartment of Translational Medical Sciences, Section of Pediatrics, “Federico II” University, NaplesChest ultrasound is a useful diagnostic tool in adult emergency medicine. Echography does not generate a clear image of the lung but is able to generate artifacts that are combined in disease-specific profiles. Reflections of the pleural image appear as short straight lines also known as A-lines. Vertical, comet-tail artifacts departing from the pleura are named B-lines. The former are present in the normal lung while the latter have been described in the adult wet lung. Lung ultrasonography outperforms conventional radiology in the emergency diagnosis of pneumothorax and pleural effusions. Neonatologists and pediatricians are now adapting lung ultrasound to their specific clinical issues. The normal image is relatively unchanged throughout the age span, while progressively fading B-lines describe the fluid-to-air transition of the neonatal lung. Also, an homogeneous white (hyperechogenic) lung with pleural image abnormalities and absence of spared areas is accurate in diagnosing Respiratory Distress Syndrome (RDS). The prevalence of A-lines in the upper lung fields with B-lines at the bottom fields (aka double lung point artifact) is highly sensitive and specific in describing Transient Tachypnea of the Newborn. Infantile pneumonia has recently been proved an accurate diagnosis by ultrasound after a short training. In summary, chest ultrasonography has no ground to replace conventional chest radiology tout court. However, when appropriately applied, a lung ultrasound scan can save time and radiation exposure to achieve a critical diagnosis.   Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy) · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge researchhttps://www.jpnim.com/index.php/jpnim/article/view/83ultrasoundlungartifactscometsneonatepneumonia
spellingShingle Francesco Raimondi
Fiorella Migliaro
Angela Sodano
Gianfranco Vallone
Teresa Ferrara
Sergio Maddaluno
Clara Coppola
Letizia Capasso
Point-of-care chest ultrasound in the Neonatal Intensive Care Unit
Journal of Pediatric and Neonatal Individualized Medicine
ultrasound
lung
artifacts
comets
neonate
pneumonia
title Point-of-care chest ultrasound in the Neonatal Intensive Care Unit
title_full Point-of-care chest ultrasound in the Neonatal Intensive Care Unit
title_fullStr Point-of-care chest ultrasound in the Neonatal Intensive Care Unit
title_full_unstemmed Point-of-care chest ultrasound in the Neonatal Intensive Care Unit
title_short Point-of-care chest ultrasound in the Neonatal Intensive Care Unit
title_sort point of care chest ultrasound in the neonatal intensive care unit
topic ultrasound
lung
artifacts
comets
neonate
pneumonia
url https://www.jpnim.com/index.php/jpnim/article/view/83
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AT gianfrancovallone pointofcarechestultrasoundintheneonatalintensivecareunit
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AT sergiomaddaluno pointofcarechestultrasoundintheneonatalintensivecareunit
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