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Indian Pediatr 2017;54: 64 |
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The Fast Growth of Neonatal Lung Ultrasound:
Authors Reply
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# Chandra Rath And
*Pradeep Suryawanshi
From Departments of
Neonatology; #Royal
North Shore Hospital, Pacific High way, St Leonards, NSW, Australia; and
*Bharati Vidyapeeth University Medical college,
Pune, Maharastra, India.
Email:
[email protected]
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We greatly appreciate the readers for their valuable suggestions
pertaining to lung ultrasound. As mentioned in the letter, it is a fact
that lung ultrasound is a rapidly expanding topic with frequent new
addition of research publications.
As far as pneumothorax is concerned we are aware of
recent publications, which showed neonatal lung ultrasound to be more
sensitive than chest X-ray, transillumination and clinical
evaluation [1]. All these studies were published recently, after we had
reviewed the literature.
We agree that transient tachpnea of newborn (TTN)
part in our review is not very comprehensive because of the numerous
topics we were covering under one heading. Double lung point has a very
high specificity and sensitivity in diagnosing TTN as per the two
prominent studies by the same group of authors [2,3]. Liu, et al.
[4] in his earlier study in 2014 showed that double lung point has a
sensitivity and specificity of 76.7% and 100%, respectively in the
diagnosis of TTN. In his recent publication [5], sensitivity and
specificity of double lung point in diagnosis of TTN was 45.6% and
94.8%, respectively. Liu, et al. [4,5] have not elaborated on the
duration of mechanical ventilation, surfactant need, gestation of
infants and its relation with ultrasound finding. The authors have also
not mentioned about the timing and number of ultrasounds, and the
interpreter was not blinded to the clinical diagnosis. TTN is often a
diagnosis of exclusion. Copetti, et al. [2,3] in their studies
had fewer infants with probably less severe TTN, which resolved within
72 hours. We attribute this discrepancy in ultrasound finding in studies
by two different groups to the different definitions of TTN. However
from the available studies, it appears that severe TTN may have an
ultrasound picture close to the ultrasound picture of respiratory
distress syndrome. Ultrasound diagnosis of TTN and its differentiation
from respiratory distress syndrome is of operational importance so that
infants with mechanical ventilation need may be transferred to a
tertiary-care center with available facilities. Hence, we still believe
double lung point has its relevance in the diagnosis of TTN.
References
1. Raimondi F, Fanjul JR, Aversa S, Chirico G, Yousef
N, Luca DD, et al. Lung ultrasound for diagnosing pneumothorax in
the critically ill neonate. J Pediatr 2016;175:74-8.
2. Vergine M, Copetti R, Brusa G, Cattarossi L. Lung
Ultrasound Accuracy in Respiratory Distress Syndrome and Transient
Tachypnea of the Newborn. Neonatology 2014; 106:87-93.
3. Copetti R, Cattarossi L. The ‘double lung point’:
an ultrasound sign diagnostic of transient tachypnea of the newborn.
Neonatology 2007;91:203-9.
4. Liu J, Wang Y, Fu W, Yang CS, Huang JJ. Diagnosis
of neonatal transient tachypnea and its differentiation from respiratory
distress syndrome using lung ultrasound. Medicine (Baltimore).
2014;93:e197.
5. Liu J, Chen XX, Li XW, Chen SW, Wang Y, Fu W. Lung
Ultrasonography to Diagnose Transient Tachypnea of the Newborn. Chest.
2016;149:1269-75.
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