Z Geburtshilfe Neonatol 2021; 225(01): 15-18
DOI: 10.1055/a-1312-7773
Übersicht

Lungenultraschall in der Neonatologie zur Diagnostik eines Pneumothorax (Teil 1): Eine Evidenzanalyse – Zeit für einen neuen Goldstandard

Lung Ultrasound in Neonatology to diagnose a Pneumothorax (part one): Evidence – Time for a New Standard Protocol
Jan Sandig
1   Klinik für Neonatologie, Charité Universitätsmedizin Berlin, Berlin
,
Christoph Bührer
1   Klinik für Neonatologie, Charité Universitätsmedizin Berlin, Berlin
,
Christoph Czernik
1   Klinik für Neonatologie, Charité Universitätsmedizin Berlin, Berlin
› Author Affiliations

Zusammenfassung

Der Lungenultraschall ist eine in der Notfallmedizin gut erforschte Untersuchungsmethode. Der Pneumothoraxausschluss mithilfe des Lungenultraschalls ist in den letzten Jahren auch bei Neugeborenen intensiv erforscht worden. Es wurden standardisierte Untersuchungsalgorithmen und unstrittige pathognomonische Untersuchungsbefunde veröffentlicht. Im Vergleich zum etablierten diagnostischen Standardverfahren, der Röntgenthoraxaufnahme, bietet der Lungenultraschall eine Reihe von Vorteilen, wobei der Verzicht auf ionisierende Strahlung und die rasche Diagnosestellung bei exzellenter Sensitivität und vergleichbarer Spezifität herausstechen. Der Lungenultraschall leistet somit einen Beitrag zur Verbesserung der Versorgungsqualität in der neonatologischen Intensivmedizin. Wir sehen daher die Nutzung des Lungenultraschalls als neues Standardverfahren in der Pneumothoraxdiagnostik beim Neugeborenen an.

Abstract

Lung ultrasound is a well-studied diagnostic procedure in emergency medicine. Over the last several years, international research groups have investigated the role of lung ultrasound to evaluate neonatal respiratory diseases. Specific diagnostic algorithms and key features of a neonatal pneumothorax have been released. Compared to X-ray examination, lung ultrasound has many advantages, such as faster diagnostic time, lack of exposure to ionizing radiation, and excellent sensitivity and specificity. Thus, lung ultrasound contributes to the improvement of medical healthcare in the neonatal intensive care unit. We consider the use of lung ultrasound as a new standard procedure to diagnose a pneumothorax in neonatology.



Publication History

Received: 15 September 2020

Accepted after revision: 05 November 2020

Article published online:
07 January 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Duong HH, Mirea L, Shah PS. et al. Pneumothorax in neonates: Trends, predictors and outcomes. J Neonatal Perinatal Med 2014; 7: 29-38
  • 2 Aly H, Massaro A, Acun C. et al. Pneumothorax in the newborn: clinical presentation, risk factors and outcomes. J Matern Fetal Neonatal Med 2014; 27: 402-406
  • 3 Joyner CR, Herman RJ, Reid JM. Reflected ultrasound in the detection and localization of pleural effusion. JAMA 1967; 200: 399-402
  • 4 Stuhlfauth K. Reflektorische Wirkungen des Ultraschalls auf die Pneumothoraxlunge. Dtsch Med Wochenschr 1951; 76: 537-538
  • 5 Lichtenstein D, Mezière G, Biderman P. et al. The „lung point“: an ultrasound sign specific to pneumothorax. Intensive Care Med 2000; 26: 1434-1440
  • 6 Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest 1995; 108: 1345-1348
  • 7 Nguyen J, Amirnovin R, Ramanathan R. et al. The state of point-of-care ultrasonography use and training in neonatal–perinatal medicine and pediatric critical care medicine fellowship programs. J Perinatol 2016; 36: 972-976
  • 8 Kurepa D, Zaghloul N, Watkins L. et al. Neonatal lung ultrasound exam guidelines. J Perinatol 2018; 38: 11-22
  • 9 Raschetti R, Yousef N, Vigo G. et al. Echography-Guided Surfactant Therapy to Improve Timeliness of Surfactant Replacement: A Quality Improvement Project. J Pediatr 2019; 212: e1
  • 10 Alonso-Ojembarrena A, Lubián-López SP. Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants. Pediatr Pulmonol 2019; 54: 1404-1409
  • 11 Alrajab S, Youssef AM, Akkus NI. et al. Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax: review of the literature and meta-analysis. Crit Care 2013; 17: R208
  • 12 Dahmarde H, Parooie F, Salarzaei M. Accuracy of Ultrasound in Diagnosis of Pneumothorax: A Comparison between Neonates and Adults-A Systematic Review and Meta-Analysis. Can Respir J 2019; 2019: 5271982
  • 13 Liu J, Kurepa D, Feletti F. et al. International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure. J Vis Exp. 2020 12.
  • 14 Singh Y, Tissot C, Fraga MV. et al. International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care. 2020 24.
  • 15 Alrajhi K, Woo MY, Vaillancourt C. Test Characteristics of Ultrasonography for the Detection of Pneumothorax: A Systematic Review and Meta-analysis. Chest 2012; 141: 703-708
  • 16 Ding W, Shen Y, Yang J. et al. Diagnosis of Pneumothorax by Radiography and Ultrasonography: A Meta-analysis. Chest 2011; 140: 859-866
  • 17 Corsini I, Parri N, Gozzini E. et al. Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates. Neonatology 2019; 115: 77-84
  • 18 Liu J, Chi J-H, Ren X-L. et al. Lung ultrasonography to diagnose pneumothorax of the newborn. Am Emerg Med 2017; 35: 1298-1302
  • 19 Raimondi F, Rodriguez Fanjul J, Aversa S. et al. Lung Ultrasound for Diagnosing Pneumothorax in the Critically Ill Neonate. J Pediatr 2016; 175: 74-78.e1
  • 20 Cattarossi L, Copetti R, Brusa G. et al. Lung Ultrasound Diagnostic Accuracy in Neonatal Pneumothorax. Can Respir J 2016; 2016: 6515069
  • 21 Ploenes T, Schildhaus H-U, Theegarten D. et al. Pleuropulmonary Blastoma Misinterpreted as Spontaneous Pneumothorax in an Infant. Ann Thorac Surg 2020; 110: e79
  • 22 Raimondi F, Migliaro F, Luca DD. et al. Clinical Data Are Essential to Validate Lung Ultrasound. Chest 2016; 149: 1575