The value of ultrasound examination of the lungs in predicting bronchopulmonary dysplasia.
BACKGROUND
Bronchopulmonary dysplasia (BPD) is one of the most serious complications of neonatal mechanical ventilation. Early diagnosis may influence treatment options such as early steroid administration.


OBJECTIVE
To assess the role of US of the lungs in predicting the development of BPD in infants with hyaline membrane disease (HMD) and to determine the earliest possible age at which the diagnosis of BPD could be made with certainty.


METHODS
Consecutive premature newborn infants requiring assisted ventilation during 1997-1998 who were admitted because of HMD were studied prospectively. US of the lungs was performed within 3 days of birth and three times a week thereafter until discharge from the neonatal intensive care unit. Each patient was also clinically and radiographically evaluated for the presence or absence of BPD at day 28 of life. Lung US scans were correlated with the development of BPD.


RESULTS
Retrodiaphragmatic hyperechogenicity (RH) was initially observed in 28 of the 36 patients with HMD, but resolved completely in 24 (96%) of 25 infants who had an uncomplicated clinical course. In eight of the ten infants who developed BPD, RH persisted. Day 9 was the earliest day where persistence of abnormal RH was observed with the highest predictor values for the development of BPD.


CONCLUSIONS
Lung US is a valuable technique for predicting the development of BPD.
Pieper
Clarissa H
CH
Neonatal Division, Department of Paediatrics and Child Health, Tygerberg Hospital, P.O. Box 19063, 7505 Tygerberg, South Africa. chp@sun.ac.za
Smith
Johan
J
Brand
Esther J
EJ
D017668:Age of Onset; D001997:Bronchopulmonary Dysplasia / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D006819:Hyaline Membrane Disease / Q000150:complications / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects*; D014463:Ultrasonography