Neonatal Intensive Care Unit, Basurto University Hospital, Bilbao, Spain.
Neonatal Intensive Care Unit, Gregorio Marañón University Hospital, Madrid, Spain.
An Pediatr (Engl Ed). 2022 Mar;96(3):252.e1-252.e13. doi: 10.1016/j.anpede.2022.01.002. Epub 2022 Mar 18.
Lung ultrasound is a useful tool for diagnosis and follow-up of diseases in critically ill neonates. Its use is increasingly widespread thanks to its advantages over other imaging tests and the rapidly growing body of evidence to support it, and "point-of-care ultrasound" (POCUS) has become a key component in neonatal guidelines. The objective of this special article is to present the foundations and the established diagnostic and therapeutic applications of lung ultrasonography as well as introducing new applications.
The Lung Ultrasound Section of the Neonatal Ultrasonography Working Group of the Spanish Neonatology Society has summarised the current scientific evidence. The article describes the sonographic features of the most common respiratory diseases, discusses some of the applications of ultrasound in neonatal care (such as prediction of admission and need of surfactant, ultrasound-guided procedures or monitoring of lung development in premature infants) and proposes its introduction in other scenarios in which its use is not quite established at present, such as resuscitation or respiratory management. This article reaffirms the usefulness of lung ultrasound in guiding diagnosis, clinical decision-making and prognosis and facilitating procedures.
Lung ultrasound should be established as the gold standard for diagnosis of respiratory diseases in neonates. Therefore, training in lung ultrasound should be included in the educational curriculum of neonatologists and in diagnostic and therapeutic care protocols. Research on the subject should continue to be pursued with performance of rigorous multicentre studies to increase the quality of the evidence.
肺部超声是诊断和监测危重新生儿疾病的有用工具。由于其相对于其他影像学检查的优势以及支持其使用的大量证据,其应用越来越广泛,“即时床边超声”(POCUS)已成为新生儿指南的重要组成部分。本文的目的是介绍肺部超声的基础以及已确立的诊断和治疗应用,并介绍新的应用。
西班牙新生儿学会新生儿超声工作组的肺部超声科总结了目前的科学证据。本文描述了最常见的呼吸系统疾病的超声特征,讨论了超声在新生儿护理中的一些应用(如预测入院和需要表面活性剂、超声引导下的程序或监测早产儿的肺部发育),并提出了在目前应用尚未确立的其他情况下引入超声的建议,例如复苏或呼吸管理。本文重申了肺部超声在指导诊断、临床决策和预后以及促进程序方面的有用性。
肺部超声应成为新生儿呼吸疾病诊断的金标准。因此,肺部超声培训应纳入新生儿科医生的教育课程以及诊断和治疗护理方案中。应继续对该主题进行研究,开展严格的多中心研究,以提高证据质量。