Diagnosis of Neonatal Transient Tachypnea and Its Differentiation from Other Causes of Neonatal Respiratory Distress Using Lung Ultrasound in Egyptian Neonates

Presenter: M. Ibrahim (e-mail: [e-mail])

Introduction: Respiratory distress is a common feature accounting for 30 to 40% of NICU admissions in the neonatal period. In this study we aimed at investigating the diagnostic value of lung ultrasonography (LUS) for early diagnosis of neonatal transient tachypnea (TTN) as well as differentiating it from other causes of neonatal respiratory distress in near and full term Egyptian neonates.

Materials and Methods: Lung ultrasonography was performed in near and full term neonates presented with respiratory distress within the first 12 to 24 hours from admission. While in a quiet state, infants were positioned in a supine, side or prone position. The lung field was divided into three areas by the anterior axillary line and posterior axillary line. The regions of the bilateral lung were scanned with the transducer, which is vertical or parallel with the ribs. A plain chest X-ray, C-reactive protein, and full blood count were performed as part of the workup for respiratory distressed neonate.

Results: Sixty-five near- and full-term neonates underwent LUS to rule out TTN. Among them, 73% were diagnosed to have TTN, 19% were diagnosed to have pneumonia, 3.2% had RDS, and 4.8% had meconium aspiration syndrome. The double-lung point has 69.6% sensitivity, 100% specificity, 100% PPV, and 39.1% NPV for detecting TTN. A positive correlation was also found between the degree of alveolar-interstitial syndrome (AIS) and the type of oxygen support needed by neonates diagnosed to have TTN.

Conclusion: LUS proved to be reliable for early, noninvasive diagnosis of TTN and early differentiation from other causes of neonatal respiratory distress in near and full-term neonates in Egypt.

Keywords: double-lung point, TTN, lung ultrasound, neonates, alveolo-interstitial syndrome