目的:探讨不同类型的探头对新生儿肺部超声的影响。
方法:前瞻性,失明,随机化,2020年至2022年的比较研究。
方法:三级新生儿单元的单中心研究。
方法:经鼻持续气道正压通气的血流动力学稳定的婴儿,高流量鼻插管或无呼吸支持。
方法:使用回声或微凸探头进行肺超声检查。作为控制,使用线性探针。
方法:主要结局指标是新生儿专家进行的肺部超声(NPLUS)评分。次要结果指标是B线数量,胸膜线厚度和主观图像质量。此外,评估了NPLUS结果与临床数据之间的相关性.
结果:共有来自66名患者的1584个视频循环,平均校正胎龄为33.8周(SD4.23),体重为1950g(SD910),分别,进行了分析。与线性探头相比,回波和微凸探头的NPLUS评分估计较低,系数为-2.95(p<0.001)和-1.09(p=0.19),分别。脉搏血氧饱和度/吸入氧比分数与NPLUS评分之间的相关性中等强且使用微凸探针最佳(Spearman'srho=-0.63,p<0.001)。
结论:我们的结果不仅证实了目前的建议,但也证明了不同的结果时,使用不同的探针的程度。我们发现的差异需要谨慎解释分数,特别是在指导治疗和沟通预后的背景下。最后,NPLUS评分和临床参数之间的相关性有助于验证该诊断工具的使用.
OBJECTIVE: To determine the effect of different types of probes for lung ultrasound in neonates.
METHODS: Prospective, blinded, randomized, comparative study between 2020 and 2022.
METHODS: Single-center study at a third level neonatal unit.
METHODS: Hemodynamically stable infants with either nasal continuous positive airway pressure, high flow nasal cannula or without respiratory support.
METHODS: Lung ultrasound using either an echo or microconvex probe. As control, the linear probe was used.
METHODS: Primary outcome measure was neonatologist performed lung ultrasound (NPLUS) score. Secondary outcome measures were number of B-Lines, thickness of the pleural line and subjective image quality. Furthermore, correlation between NPLUS results and clinical data was assessed.
RESULTS: A total of 1584 video loops from 66 patients, with a mean corrected gestational age of 33.8 weeks (SD 4.23) and weight of 1950g (SD 910), respectively, were analyzed. NPLUS score was estimated lower with the echo- and microconvex probe compared to the linear probe, with a coefficient of -2.95 (p < 0.001) and -1.09 (p = 0.19), respectively. Correlation between the pulse oximetric saturation/fraction of inspired oxygen ratio and NPLUS score was moderately strong and best using the microconvex probe (Spearman\'s rho = -0.63, p<0.001).
CONCLUSIONS: Our results not only confirm the current recommendations, but also demonstrate the extent of the varying results when different probes are used. The differences we discovered call for caution in interpreting scores, especially in the context of guiding therapies and communicating prognoses. Finally, the correlation between NPLUS score and clinical parameters contributes to validating the use of this diagnostic tool.