Department of Neonatology and Neonatal Intensive Care Unit, Huizhou Central People's Hospital, Guangdong, China.
Department of Neonatology and Neonatal Intensive Care Unit, Beijing Chaoyang District Maternal and Child Healthcare Hospital, Beijing, China; and National Neonatal Lung Ultrasound Training Base, Beijing, China..
Med Ultrason. 2020 Sep 5;22(3):325-333. doi: 10.11152/mu-2485. Epub 2020 Apr 15.
Neonatal respiratory distress syndrome (NRDS) is one of the most common and severe diseases in neonatal intensive care units worldwide. Increasing evidence suggests that lung ultrasound (LUS) may be a reliable diagnostic tool for neonatal respiratory distress syndrome. The aim of study was to evaluate the diagnostic accuracy of LUS for NRDS with a systematic review and meta-analysis.
We searched for articles in EMBASE, PubMed and Cochrane Central from inception until 17 August 2019. The selected studies were diagnostic accuracy studies that reported the utility of LUS in the diagnosis of NRDS. Two researchers independently extracted data and assessed quality using the QUADAS-2 tool. Then, we created a bivariate mixed effects model to calculate the sensitivity and specificity of LUS in diagnosing NRDS. A summary receiver operator characteristic (SROC) curve was constructed to summarize the performance characteristics of LUS.
Nine studies involving 703 infants were included in the review. LUS had a pooled sensitivity of 0.99 (CI: 0.92-1.00) and a specificity of 0.95 (CI: 0.87-0.98). The areas under the curve for LUS was 0.99 (0.98-1.0). Meta-regression revealed that LUS had a significant diagnostic accuracy for NRDS.
LUS is a promising method that is easily carried out, inexpensive, nonionizing and repeatable and can be performed at the bedside. Current evidence supports LUS as a useful imaging alternative for the diagnosis of NRDS.
新生儿呼吸窘迫综合征（NRDS）是全球新生儿重症监护病房中最常见和最严重的疾病之一。越来越多的证据表明，肺部超声（LUS）可能是诊断新生儿呼吸窘迫综合征的一种可靠工具。本研究旨在通过系统评价和荟萃分析评估 LUS 对 NRDS 的诊断准确性。
我们在 EMBASE、PubMed 和 Cochrane Central 数据库中检索了从建库至 2019 年 8 月 17 日的文章。入选的研究为报告 LUS 在 NRDS 诊断中应用的诊断准确性研究。两名研究者独立提取数据，并使用 QUADAS-2 工具评估质量。然后，我们创建了一个二变量混合效应模型来计算 LUS 诊断 NRDS 的敏感性和特异性。绘制汇总受试者工作特征（SROC）曲线来总结 LUS 的性能特征。
共有 9 项研究纳入了 703 例婴儿。LUS 的汇总敏感性为 0.99（95%CI：0.92-1.00），特异性为 0.95（95%CI：0.87-0.98）。LUS 的曲线下面积为 0.99（0.98-1.0）。Meta 回归显示 LUS 对 NRDS 具有显著的诊断准确性。
LUS 是一种有前途的方法，它易于操作、价格低廉、无放射性且可重复，并可在床边进行。目前的证据支持 LUS 作为一种有用的替代成像方法来诊断 NRDS。
