Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1827
Peer-review started: December 1, 2020
First decision: December 24, 2020
Revised: January 6, 2021
Accepted: January 25, 2021
Article in press: January 25, 2021
Published online: March 16, 2021
Patent ductus arteriosus (PDA) has a high incidence in neonates with very low-birth weights, and abnormal circulation hemodynamics and pulmonary edema may occur in persistent PDA. Lung ultrasonography was reported to be a quantitative method for assessment of lung water content. However, there are few studies reporting its role in neonates with PDA.
With recent advancements in lung ultrasonography, the detection of a variety of lung diseases in neonates has improved markedly. The advantages of bedside, radiation free, relatively cheap and reproducible would make it widely used in clinical work.
To evaluate lung water content and predict the possibility of hemodynamic changes in very low-weight preterm neonates with PDA.
In this study, we performed cardiopulmonary ultrasonography in neonates with or without PDA and compared the ultrasonography results including left ventricular ejection fraction, left atrium to aortic dimension ratio and lung ultrasonography score (LUS) between the two groups.
Results showed that the LUS and left atrium to aortic ratio were higher in neonates with PDA, and the LUS was positively correlated with PDA diameter and left atrium to aortic ratio, indicating that the lung water content was higher in PDA. In addition, the receiver operating characteristic curve showed that the LUS had moderate accuracy for predicting the possibility of hemodynamic changes. The area under the curve was 0.741 (95% confidence interval: 0.621-0.839), and sensitivity and specificity were 93.75% and 50.94%, respectively.
We conclude that bedside cardiopulmonary ultrasonography can evaluate lung water content and predict the possibility of hemodynamic changes in very low-weight preterm neonates with PDA.
The LUS is subjective and operator dependent. A more objective and appropriate evaluation method should be identified. In addition, neonatal lungs are complex, different diseases can have the same ultrasound images, the LUS alone cannot reflect its severity, and comprehensive evaluation is needed.