Blank Douglas A, Kamlin C Omar Farouk, Rogerson Sheryle R, Fox Lisa M, Lorenz Laila, Kane Stefan Charles, Polglase Graeme R, Hooper Stuart B, Davis Peter G
Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia.
The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
Arch Dis Child Fetal Neonatal Ed. 2018 Mar;103(2):F157-F162. doi: 10.1136/archdischild-2017-312818. Epub 2017 Jun 28.
Lung ultrasound (LUS) has shown promise as a diagnostic tool for the evaluation of the newborn with respiratory distress. No study has described LUS during 'normal' transition. Our goal was to characterise the appearance of serial LUS in healthy newborns from the first minutes after birth until airway liquid clearance is achieved.
Prospective observational study.
Single-centre tertiary perinatal centre in Australia.
Of 115 infants born at ≥35 weeks gestational age, mean (SD) gestational age of 38 weeks±11 days, mean birth weight of 3380±555 g, 51 were delivered vaginally, 14 via caesarean section (CS) after labour and 50 infants via elective CS.
We obtained serial LUS videos via the right and left axillae at 1-10 min, 11-20 min and 1, 2, 4 and 24 hours after birth.
LUS videos were graded for aeration and liquid clearance according to a previously validated system.
We analysed 1168 LUS video recordings. As assessed by LUS, lung aeration and airway liquid clearance occurred quickly. All infants had an established pleural line at the first examination (median=2 (1-4) min). Only 14% of infants had substantial liquid retention at 10 min after birth. 49%, 78% and 100% of infants had completed airway liquid clearance at 2, 4 and 24 hours, respectively.
In healthy transitioning newborn infants, lung aeration and partial liquid clearance are achieved on the first minutes after birth with complete liquid clearance typically achieved within the first 4 hours of birth.
ANZCT 12615000380594.
肺部超声（LUS）已显示出有望成为评估呼吸窘迫新生儿的诊断工具。尚无研究描述“正常”过渡期间的LUS情况。我们的目标是描绘健康新生儿从出生后最初几分钟到气道液体清除完成期间连续LUS的表现。
前瞻性观察性研究。
澳大利亚的单中心三级围产期中心。
115名胎龄≥35周的婴儿，平均（标准差）胎龄为38周±11天，平均出生体重为3380±555克，其中51名经阴道分娩，14名在分娩后经剖宫产（CS），50名婴儿经择期剖宫产。
我们在出生后1 - 10分钟、11 - 20分钟以及1、2、4和24小时通过左右腋窝获取连续的LUS视频。
根据先前验证的系统对LUS视频的通气和液体清除情况进行分级。
我们分析了1168份LUS视频记录。通过LUS评估，肺部通气和气道液体清除迅速发生。所有婴儿在首次检查时（中位数 = 2（1 - 4）分钟）均已建立胸膜线。出生后10分钟时，只有14%的婴儿有大量液体潴留。分别有49%、78%和100%的婴儿在2、4和24小时时完成了气道液体清除。
在健康过渡的新生儿中，出生后最初几分钟内实现肺部通气和部分液体清除，通常在出生后4小时内实现完全液体清除。
ANZCT 12615000380594。
