The Clinical Value of Bedside Pulmonary Ultrasound in the Diagnosis and Treatment of Critical Neonatal Pneumothorax

Abstract

Abstract:

Objective： To explore the diagnostic value of bedside pulmonary ultrasound in neonatal pneumothorax and its suitability for promotion in primary hospitals. Methods： A prospective study was conducted on critically ill newborns with suspected of pneumothorax admitted to the neonatal intensive care unit of Kunming Children's Hospital from January 2021 to October 2022. The enrolled patients received both bedside ultrasonography and X-ray examination. Based on clinical manifestations， the accuracy and duration of the two methods were compared. Results： A total of 66 pneumothorax cases were confirmed among the 76 cases， of which 66 cases were confirmed by pulmonary ultrasound and 55 cases were confirmed by X-ray. According to the analysis of McNemar's and Kappa tests， the difference in diagnostic accuracy between the two methods was statistically significant（P<0.001）， and the diagnostic results were moderately consistent （Kappa=0.656）. The duration of pulmonary ultrasound examination was 5.63 minutes shorter than that of X-ray examination， and the difference was statistically significant（P<0.001）. Conclusion： Bedside pulmonary ultrasound is easy to learn， and is an efficient and convenient method for the diagnosis and treatment of neonatal pneumothorax. It is superior to X-ray imaging and is suitable for promotion in primary hospitals.

Key words:

pulmonary ultrasound, pneumothorax, critically ill newborns

CLC Number:

R72 ','1');return false;" target="_blank">
R72

Bao Lingyun, Yin Lijuan.

The Clinical Value of Bedside Pulmonary Ultrasound in the Diagnosis and Treatment of Critical Neonatal Pneumothorax [J]. Journal of Dali University, 2023, 8(10): 64-67.

References

〔1〕 ALI R， AHMED S， QADIR M， et al. Pneumothoraces in a Neonatal Tertiary Care Unit： Case Series〔J〕. Oman Med J， 2013， 28（1）： 67-69.

〔2〕刘敬，曹海英，程秀永.新生儿肺脏疾病超声诊断学〔M〕.2版.郑州：河南科学技术出版社，2019：204-207.

〔3〕邵肖梅，叶鸿瑁，丘小汕.实用新生儿学〔M〕.5版.北京：人民卫生出版社，2019：592-594.

〔4〕刘敬.中国儿童肺脏超声医学回顾与展望〔J〕.中国实用儿科杂志，2019，34（9）：753-756.

〔5〕刘敬，张丽，邱如新.《新生儿气胸超声诊断和超声监测下胸腔穿刺治疗术国际专家共识与建议》解读〔J〕.中国小儿急救医学，2020，27（5）：349-353.

〔6〕 LIU J， CHI J H， REN X L， et al. Lung Ultrasonography to Diagnose Pneumothorax of the Newborn〔J〕. Am J Emerg Med， 2017， 35（9）： 1298-1302.

〔7〕 SMITH J， SCHUMACHER R E， DONN S M， et al. Clinical Course of Symptomatic Spontaneous Pneumo-thorax in Term and Late Preterm Newborns： Report from a Large Cohort〔J〕. Am J Perinatol， 2011， 28（2）： 163-168.

〔8〕 ALY H， MASSARO A， ACUN C， et al. Pneumothorax in the Newborn： Clinical Presentation， Risk Factors and Outcomes〔J〕. J Matern Fetal Neonatal Med， 2014， 27（4）： 402-406.

〔9〕 DUONG H H， MIREA L， SHAH P S， et al. Pneumo-thorax in Neonates： Trends， Predictors and Outcomes〔J〕. J Neonatal Perinatal Med， 2014， 7（1）： 29-38.

〔10〕 BOO N Y， CHEAH I G S， REGISTRY M N N. Risk Factors Associated with Pneumothorax in Malaysian Neonatal Intensive Care Units〔J〕. J Paediatr Child Health， 2011， 47（4）： 183-190.

〔11〕 SALAZAR A J， AGUIRRE D A， OCAMPO J， et al. Evaluation of Three Pneumothorax Size Quantification Methods on Digitized Chest X-Ray Films Using Medical-Grade Grayscale and Consumer-Grade Color Displays〔J〕. J Digit Imaging， 2014， 27（2）： 280-286.

〔12〕 MUSALAR E， EKINCI S， NEK O， et al. Conventional vs Invert-Grayscale X-Ray for Diagnosis of Pneumo-thorax in the Emergency Setting〔J〕. Am J Emerg Med， 2017， 35（9）： 1217-1221.

〔13〕中华医学会儿科学分会围产医学专业委员会，中国医师协会新生儿科医师分会超声专业委员会，中国医药教育协会超声医学专业委员会重症超声学组，等.新生儿肺脏疾病超声诊断指南〔J〕.中国当代儿科杂志，2019，21（2）：105-113.