Lung Ultrasonography to Diagnose Bronchopulmonary Dysplasia in Premature Infants

AUTHORS

Jing Liu 1 , 2 , * , Jing-Han Chi 2 , Wei Fu 1 , 2 , Li Zhang 1 , Ru-Xin Qiu 1

1 Department of Neonatology and NICU, Beijing Chaoyang District Maternal and Child Healthcare Hospital, Beijing, China

2 Department of Neonatology and NICU, Bayi Children’s Hospital Affiliated to the Seventh Medical Center of Chinese PLA General Hospital, Beijing, China

How to Cite: Liu J, Chi J, Fu W, Zhang L, Qiu R. Lung Ultrasonography to Diagnose Bronchopulmonary Dysplasia in Premature Infants, Iran J Pediatr.2021 31(3): e109598. doi: 10.5812/ijp.109598.

ARTICLE INFORMATION

Iranian Journal of Pediatrics: 31 (3); e109598
Published Online: May 31, 2021
Article Type: Research Article
Received: September 20, 2020
Revised: May 07, 2021
Accepted: May 09, 2021
Primary Published scheduled for 31 (4)
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Abstract

Objectives: Bronchopulmonary dysplasia (BPD) is a common severe respiratory problem in premature infants, imaging information has important reference value for its diagnosis.Recently,lung ultrasonography (LUS) has been successfully used in the diagnosis and differential diagnosis of neonatal lung diseases (NLDs),but the study on the diagnosis of BPD is still rare.The purpose of this study was to investigate the ultrasonographic characteristics of BPD and its value in the diagnosis and differential diagnosis of premature infant BPD.

Methods: From January 2015 to December 2019,25 premature infants diagnosed with early-stage BPD and 32 infants diagnosed with late-stage BPD according to their medical history,clinical manifestation and chest X-ray were included in this study LUS examination were performed on each infants.The LUS findings were recorded and compared with that of 40 premature infants without lung diseases.

Results: The gestational age of 25 early BPD infants was 26+1-31+6 weeks and their birth weight was between 730 and 1810g.The gestational age of 32 late-stage BPD infants was 26-32 weeks and their birth weight was 750-1760g.The gestational age of the 40 control infants was 25+6-32+1 week and their birth weight was 810-2050g. (2) There was no difference in the proportion of their primary lung diseases (including RDS,TTN,pneumonia,etc.) among the three groups.(3)Respiratory support:the proportion of infants receiving invasive or/and non-invasive respiratory support at admission in the three groups of early BPD,late BPD and normal control was 20/25 (80.0%), 26/32 (81.2%) and 33/40 (77.5%),respectively,there was no significant difference (p> 0.05).The mechanical ventilation duration over 1 week in three groups was 15/20 (75%), 21/26 (80.7%) and 24/33 (72.7%), respectively,there was no significant difference (p> 0.05).(4)LUS manifestations:Nonspecific pleural line abnormalities was seen in all the early and late BPD patients (100%),alveolar-interstitial syndrome(AIS) in 16 cases (64%) of early- and 32 cases of late BPD infants (100%),pleural insect erosion-like change (PIE-like change) in 2 cases of early-stage BPD infants (8.0%) and 20 cases (62.5%) of late-stage BPD infants,air vesicle signs (AVS) was seen only in 17 cases of late-stage BPD infants.The sensitivity and specificity of PIE-like change for the diagnosis of late-stage BPD were 62.5% and 92.0%,respectively,and the sensitivity and specificity of VIS for the diagnosis of late-stage BPD were 53.1% and 100%,respectively.

Conclusions: LUS is not specific for the diagnosis of early-stage BPD,but has a high reference value and specificity for the diagnosis of late-stage BPD when with obvious pulmonary fibrosis and pulmonary vesicle formation,which is mainly manifested by AIS,PIE-like change and AVS.

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© 2021, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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