Yu LF, Xu CK, Zhao M, Niu L, Huang XM, Zhang ZQ. Bedside cardiopulmonary ultrasonography evaluates lung water content in very low-weight preterm neonates with patent ductus arteriosus. World J Clin Cases 2021; 9(8): 1827-1834 [PMID: 33748231 DOI: 10.12998/wjcc.v9.i8.1827]
Corresponding Author of This Article
Min Zhao, MD, Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. hzzhaomin@126.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2021; 9(8): 1827-1834 Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1827
Bedside cardiopulmonary ultrasonography evaluates lung water content in very low-weight preterm neonates with patent ductus arteriosus
Li-Fang Yu, Chen-Ke Xu, Min Zhao, Lin Niu, Xian-Mei Huang, Zhi-Qun Zhang
Li-Fang Yu, Chen-Ke Xu, Min Zhao, Lin Niu, Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Xian-Mei Huang, Zhi-Qun Zhang, Department of Pediatrics, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Zhao M, Huang XM and Zhang ZQ designed the research; Niu L and Zhao M performed the research; Yu LF and Xu CK collected and analyzed the data; Yu LF, Xu CK and Zhao M wrote the paper.
Supported byZhejiang Medical and Health Science and Technology Project, No. 2020ky690; and Zhejiang Natural Science Public Welfare Fund, No. LGF20H020004.
Institutional review board statement: This study was approved by the ethics committee of Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Zhao, MD, Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. hzzhaomin@126.com
Received: December 1, 2020 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 Processing time: 94 Days and 2.6 Hours
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
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.
Research objectives
To evaluate lung water content and predict the possibility of hemodynamic changes in very low-weight preterm neonates with PDA.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
