Tandircioglu Umit Ayse, Melekoglu Nuriye Asli
Department of Pediatrics, Kırıkkale University, Kırıkkale, TUR.
Department of Pediatrics, Malatya Turgut Özal University Faculty of Medicine, Malatya, TUR.
Cureus. 2023 Jul 11;15(7):e41716. doi: 10.7759/cureus.41716. eCollection 2023 Jul.
Introduction Lung ultrasonography (LUS) has become frequently used in neonatal intensive care units (NICU) because it is diagnostic, useful, harmless, radiation-free, and practical for bedside use due to its portability. Objective This study aimed to evaluate the association between lung ultrasound (LUS) scores and diagnoses of neonates hospitalized for respiratory distress and determine the value of the combined use of laboratory and imaging methods in patient evaluation by looking at the correlation between blood gas parameters and LUS score. Materials and methods Between March and July 2022, a total of 55 patients who were born term or premature and admitted due to respiratory distress in the NICU of Malatya Training and Research Hospital were included in the study. In this observational, prospective study, demographic information such as birth weights, gestational weeks, mode of delivery, Apgar scores, blood gas sample results, LUS results and scores, ventilation types, and discharge time were recorded during hospitalization in our unit. According to the newborns' clinical, laboratory, and radiologic evaluations, the diagnoses of respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), or congenital pneumonia were made, and the relationship between the diagnoses and LUS scores was evaluated. The pH value and PCO2 value in the venous blood gas obtained on the day of LUS were recorded. Correlation analysis was performed between the LUS score and pH value, LUS score and PCO2 value. Results Twenty-seven newborns were diagnosed with TTN, 18 with RDS, and 10 with congenital pneumonia. There was a statistical difference between LUS scores and diagnoses (p<0.001). According to Spearman correlation analysis, a significant negative moderate correlation was found between LUS scores and venous blood gas pH value (p<0.001, r:-0.49). There was also a significant positive low, moderate correlation with venous blood gas PCO2 value (p<0.001, r:0.36). Conclusion This study demonstrates that LUS scoring has a role in determining the severity of disease and making diagnoses in patients hospitalized for respiratory distress. When LUS is widely used, it will be informative about the severity and prognosis of the disease, together with laboratory evaluation.
引言
肺部超声检查（LUS）在新生儿重症监护病房（NICU）中已得到广泛应用，因为它具有诊断性、实用性、无害性、无辐射，且因其便携性适用于床边检查。
目的
本研究旨在评估肺部超声（LUS）评分与因呼吸窘迫住院的新生儿诊断之间的关联，并通过观察血气参数与LUS评分之间的相关性，确定实验室检查和影像学检查联合使用在患者评估中的价值。
材料与方法
2022年3月至7月，共有55名足月或早产、因呼吸窘迫入住马拉蒂亚培训与研究医院NICU的患者纳入本研究。在这项观察性前瞻性研究中，记录了患者住院期间的出生体重、孕周、分娩方式、阿氏评分、血气样本结果、LUS结果与评分、通气类型以及出院时间等人口统计学信息。根据新生儿的临床、实验室和影像学评估结果，做出呼吸窘迫综合征（RDS）、新生儿短暂性呼吸急促（TTN）或先天性肺炎的诊断，并评估诊断与LUS评分之间的关系。记录LUS检查当天采集的静脉血气中的pH值和PCO₂值。对LUS评分与pH值、LUS评分与PCO₂值进行相关性分析。
结果
27名新生儿被诊断为TTN，18名被诊断为RDS，10名被诊断为先天性肺炎。LUS评分与诊断之间存在统计学差异（p<0.001）。根据Spearman相关性分析，LUS评分与静脉血气pH值之间存在显著的中度负相关（p<0.001，r：-0.49）。与静脉血气PCO₂值也存在显著的低度至中度正相关（p<0.001，r：0.36）。
结论
本研究表明，LUS评分在确定因呼吸窘迫住院患者的疾病严重程度和做出诊断方面具有作用。当LUS得到广泛应用时，它将与实验室评估一起，为疾病的严重程度和预后提供信息。
