Background: Respiratory distress is one of the most common reasons for admission to the neonatal intensive care unit. Differentiation of the causes of respiratory distress is important for the neonatologist as treatment differs with different etiologies. Conventionally, chest X-ray has been used to identify the etiology of neonatal respiratory distress but these modalities have several limitations which make their use in neonatal intensive care unit (NICU) questionable. In recent decades, there has been increased use of lung ultrasound to identify and differentiate the etiologies of neonatal respiratory distress.
Objective: this study was designed to determine the diagnostic accuracy of lung ultrasonography in identification of neonatal respiratory disorders in comparison with chest radiography.
Patients and Methods: this is a cross sectional comparative study that was carried out during the period from September 2019 to March 2021 on 100 neonates who were suffering from respiratory distress and were admitted to neonatal intensive care unit at Bab-Elshereya University Hospital, they were selected by simple random method. Each included patients were submitted to medical history taking, complete clinical examination, laboratory investigations, chest radiography and chest ultrasonography.
Results: In the present work, males were 62/100 (62%) while; females were 38/100 (38%). Mean gestational age was 36.05 ± 2.70 weeks and mean birth weight was 2720.40 ± 678.52 grams. Patients were finally diagnosed according to clinical, laboratory and radiological findings. From the transient tachypnea of newborn (TTN) patients (36), 33 were diagnosed by chest ultrasound and 29 were diagnosed by chest radiography. Patients with respiratory distress syndrome (RDS) (29 patients), 28 were diagnosed by chest ultrasound and 26 were diagnosed by chest radiography. From the cases with neonatal pneumonia (16 patients), 14 were diagnosed by chest ultrasound and 13 were diagnosed by chest radiography. From the finally diagnosed meconium aspiration syndrome (MAS) 14 patients, 12 were diagnosed by chest ultrasound and 11 were diagnosed by chest radiography. All cases with pneumothorax (4 cases) and congenital diaphragmatic hernia (CDH) (one case) were diagnosed equally by chest ultrasound and chest radiography.
Conclusion: Chest ultrasound is a simple, safe, low-cost and widely used tool that can be done by clinician with no need for too much training with high specificity and sensitivity. The accuracy of chest ultrasonography in screening and diagnosis of neonatal respiratory disorders is the same as chest radiography (chest X-ray).