Iuri Corsini1, Niccolò Parri2, Elena Gozzini3, Caterina Coviello3, Valentina Leonardi3, Chiara Poggi3, Martina Giacalone4, Tommaso Bianconi3, Lorenzo Tofani5, Francesco Raimondi6, Carlo Dani3,5. 1. Division of Neonatology, Careggi University Hospital of Florence, Florence, Italycorsiniiuri@gmail.com. 2. Department of Pediatric Emergency Medicine and Trauma Center, Meyer University Children's Hospital, University of Florence, Florence, Italy. 3. Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy. 4. Department of Health Sciences, Meyer Children's University Hospital, University of Florence, Florence, Italy. 5. Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Florence, Florence, Italy. 6. Division of Neonatology, Department of Translational Medical Sciences, Università Federico II di Napoli, Naples, Italy.
Abstract
BACKGROUND: Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking. OBJECTIVE: To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life. METHODS: We enrolled newborns with RD during the first 24 h of life. Patients underwent LUS and CXR. LUS and CXR diagnosis were compared to evaluate concordance. Twenty percent of patients received two LUS (one from an experienced and one from a novice sonographer) to calculate the interobserver agreement. The difference in time needed to reach a diagnosis with LUS and CXR, and from novice and expert operators, was measured. RESULTS: We studied 124 patients; 134 diagnoses were reported. The concordance between LUS and CXR diagnosis was 91% (95% CI 86-96%) with a κ statistic of 0.88 (95% CI 0.81-0.94). The median time to diagnosis was shorter for LUS (9.5 min, IQR 5-15) than for CXR (50 min, IQR 33-64) (p < 0.0001). In 25/124 patients, LUS was performed by both novice and experienced sonographers with complete concordance. The median time to diagnosis was shorter for expert (9 min, IQR 5-15) than novice operators (15 min, IQR 10-20) (p < 0.0002). CONCLUSION: LUS and CXR have a high concordance in the differential diagnosis of neonatal RD in the first 24 h of life. LUS has a shorter operation time than CXR.
BACKGROUND: Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking. OBJECTIVE: To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life. METHODS: We enrolled newborns with RD during the first 24 h of life. Patients underwent LUS and CXR. LUS and CXR diagnosis were compared to evaluate concordance. Twenty percent of patients received two LUS (one from an experienced and one from a novice sonographer) to calculate the interobserver agreement. The difference in time needed to reach a diagnosis with LUS and CXR, and from novice and expert operators, was measured. RESULTS: We studied 124 patients; 134 diagnoses were reported. The concordance between LUS and CXR diagnosis was 91% (95% CI 86-96%) with a κ statistic of 0.88 (95% CI 0.81-0.94). The median time to diagnosis was shorter for LUS (9.5 min, IQR 5-15) than for CXR (50 min, IQR 33-64) (p < 0.0001). In 25/124 patients, LUS was performed by both novice and experienced sonographers with complete concordance. The median time to diagnosis was shorter for expert (9 min, IQR 5-15) than novice operators (15 min, IQR 10-20) (p < 0.0002). CONCLUSION: LUS and CXR have a high concordance in the differential diagnosis of neonatal RD in the first 24 h of life. LUS has a shorter operation time than CXR.
Authors: Fiorella Migliaro; Serena Salomè; Iuri Corsini; Daniele De Luca; Letizia Capasso; Diego Gragnaniello; Francesco Raimondi Journal: Early Hum Dev Date: 2020-09-10 Impact factor: 2.079
Authors: Javier Rodriguez-Fanjul; I Jordan; M Balaguer; A Batista-Muñoz; M Ramon; S Bobillo-Perez Journal: Eur J Pediatr Date: 2020-07-24 Impact factor: 3.183