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在新生儿重症监护病房中实施标准化肺部超声协议以诊断呼吸窘迫:一项观察性研究。

Implementation of a standardized lung ultrasound protocol for respiratory distress in a neonatal intensive care unit: an observational study.

机构信息

Chair and Department of Radiology in Zabrze, Medical University of Silesia, Zabrze, Poland.

出版信息

J Perinatol. 2024 Sep;44(9):1264-1268. doi: 10.1038/s41372-024-01900-y. Epub 2024 Feb 15.

DOI:10.1038/s41372-024-01900-y
PMID:38361003
Abstract

OBJECTIVE

To assess the feasibility of implementing a simple point-of-care lung ultrasound (LU) evaluation and reporting protocol in a neonatal intensive care unit (NICU) and its effect on patient management.

STUDY DESIGN

Retrospective observational study of LU examinations performed in a level III NICU. Each examination was performed according to a standardized protocol. An independent radiologist-assessed chest X-ray (CXR) was used to compare the LU diagnosis. The impact on patient management was also evaluated.

RESULT

A total of 206 LU studies in 158 neonates were reviewed. There was significant agreement between LU and CXR diagnoses (84.95%, 95% CI 80.07-89.83%). LU affected patient management in 87.8% of the cases (95% CI 83.33-92.28%).

CONCLUSION

Implementation of a simplified, sign-based protocol for LU in the NICU is feasible. LU is not inferior to CXR studies and supports patient management as an imaging modality.

摘要

目的

评估在新生儿重症监护病房(NICU)实施简单的即时床边肺部超声(LU)评估和报告方案的可行性,及其对患者管理的影响。

研究设计

对三级 NICU 进行的 LU 检查进行回顾性观察性研究。每次检查均按照标准化方案进行。使用独立的放射科医生评估的胸部 X 线(CXR)来比较 LU 诊断。还评估了对患者管理的影响。

结果

共回顾了 158 例新生儿的 206 次 LU 研究。LU 和 CXR 诊断之间存在显著一致性(84.95%,95%置信区间 80.07-89.83%)。在 87.8%的情况下(95%置信区间 83.33-92.28%),LU 影响了患者管理。

结论

在 NICU 中实施简化的、基于征象的 LU 方案是可行的。LU 并不逊于 CXR 研究,可作为一种影像学方法支持患者管理。

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本文引用的文献

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Neonatal point-of-care lung ultrasound: a UK-wide survey and the way forward.新生儿床旁肺部超声检查:一项全英国范围的调查及未来发展方向
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加拿大曼尼托巴省新生儿重症监护中即时肺部超声服务:五年经验
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Lung ultrasound in the neonatal intensive care unit: Review of the literature and future perspectives.新生儿重症监护病房中的肺部超声:文献回顾与未来展望。
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Point-of-care ultrasound in the neonatal ICU.新生儿 ICU 的床边超声检查。
Curr Opin Pediatr. 2020 Apr;32(2):216-227. doi: 10.1097/MOP.0000000000000863.
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Lung ultrasound in preterm infants with respiratory distress: experience in a neonatal intensive care unit.早产儿呼吸窘迫症的肺部超声检查:新生儿重症监护病房的经验。
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Point of care ultrasound (POCUS) in Canadian neonatal intensive care units (NICUs): where are we?加拿大新生儿重症监护病房(NICU)中的床旁超声检查(POCUS):我们目前的情况如何?
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