Lungenultraschall in der Neonatologie zur Diagnostik eines Pneumothorax (Teil 2): Eine Praxisanleitung

Zusammenfassung

Der Lungenultraschall bietet eine rasche und zuverlässige Diagnostik zum Ausschluss eines Pneumothorax. Im vorliegenden Artikel wird der Untersuchungsablauf einer Lungenultraschalluntersuchung in der Neonatologie beschrieben. In diesem Zusammenhang ist das Verständnis und die Deutung wichtiger Artefakte und Muster, wie dem Pleuragleiten, A- und B-Linien sowie dem Lungenpunkt essenziell. Mithilfe dieser Untersuchungsbefunde lassen sich Rule-in- und Rule-out-Kriterien in der Pneumothoraxdiagnostik beschreiben. Der Lungenultraschall kann somit einen Beitrag zur Strahlenreduktion in der Neonatologie leisten.

Abstract

Lung ultrasound is a fast and reliable diagnostic tool in the detection of a neonatal pneumothorax. This tutorial provides basic information for understanding and detecting the generated artefacts, such as A-lines, B-lines, and the lung point. Essential knowledge of these artefacts allows for rule-in and rule-out criteria of a pneumothorax diagnosis. Lung ultrasound could help to reduce the use of radiation in neonatology in the future.

Schlüsselwörter

Neonatologie - Pneumothorax - POCUS - Lungenultraschall

Key words

neonatology - pneumothorax - POCUS - lung ultrasound

Publication History

Received: 15 September 2020

Accepted after revision: 05 November 2020

Article published online:
22 December 2020

• Literatur

• 1 DEGUM | Deutsche Gesellschaft für Ultraschall in der Medizin. Ultraschall und Corona. (29.05.2020). Im Internet: https://www.degum.de:443/aktuelles/presse-medien/pressemitteilungen/im-detail/news/ultraschall-und-corona.html Stand: 06.09.2020
• 2 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: 65
• 3 Cattarossi L, Copetti R, Brusa G. et al. Lung Ultrasound Diagnostic Accuracy in Neonatal Pneumothorax. Canadian Respiratory Journal 2016; 2016: e6515069
• 4 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
• 5 Corsini I, Parri N, Ficial B. et al. Lung ultrasound in the neonatal intensive care unit: Review of the literature and future perspectives. Pediatric Pulmonology 2020; 55: 1550-1562
• 6 Kurepa D, Zaghloul N, Watkins L. et al. Neonatal lung ultrasound exam guidelines. J Perinatol 2018; 38: 11-22
• 7 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: 157
• 8 Liu J, Copetti R, Sorantin E. et al. Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus. J Vis Exp 2019; 6: 145
• 9 Gomond-Le Goff C, Vivalda L, Foligno S. et al. Effect of Different Probes and Expertise on the Interpretation Reliability of Point-of-Care Lung Ultrasound. Chest 2020; 157: 924-931
• 10 Louis D, Belen K, Farooqui M. et al. Prone versus Supine Position for Lung Ultrasound in Neonates with Respiratory Distress. Am J Perinatol. 2019
• 11 Blank DA, Kamlin COF, Rogerson SR. et al. Lung ultrasound immediately after birth to describe normal neonatal transition: an observational study. Arch Dis Child Fetal Neonatal Ed 2018; 103: F157-F162
• 12 Alonso-Ojembarrena A, Lubian-Lopez SP. Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants. Pediatr Pulmonol 2019; 54: 1404-1409
• 13 Lichtenstein D, Mezière G, Biderman P. et al. The „lung point“: an ultrasound sign specific to pneumothorax. Intensive Care Med 2000; 26: 1434-1440
• 14 Küng E, Aichhorn L, Berger A. et al. Mirrored Ribs: A Sign for Pneumothorax in Neonates. Pediatr Crit Care Med 2020; 21: e944-e947
• 15 Su E, Dalesio N, Pustavoitau A. Point-of-care ultrasound in pediatric anesthesiology and critical care medicine. Can J Anaesth 2018; 65: 485-498
• 16 Ploenes T, Schildhaus H-U, Theegarten D. et al. Pleuropulmonary Blastoma Misinterpreted as Spontaneous Pneumothorax in an Infant. Ann Thorac Surg 2020; 110: e79
• 17 Raimondi F, Migliaro F, Luca DD. et al. Clinical Data Are Essential to Validate Lung Ultrasound. Chest 2016; 149: 1575