title: Diagnosis of neonatal transient tachypnea and its differentiation from respiratory distress syndrome using lung ultrasound.
abstract: Transient tachypnea of the newborn (TTN) is one of the most common causes of perinatal dyspnea and is traditionally diagnosed by chest x-ray. This study aimed to explore the diagnostic value of lung ultrasonography (LUS) for TTN as well as differentiate it from respiratory distress syndrome (RDS) by using LUS. From January 2013 to February 2014, 60 infants who were diagnosed with TTN based on medical history, clinical manifestations, arterial blood gas analysis, and chest radiography were recruited to the study group. During the same period, 40 hospitalized neonates with nonlung diseases and 20 patients with RDS were recruited to the control group. In a quiet state, infants were placed in the supine, lateral, or prone position for the examination. Each lung of every infant was divided into 3 regions: the anterior, lateral, and posterior regions as bordered by the anterior axillary and posterior axillary lines. The probe was placed perpendicular to the ribs. Each region of both the lungs was carefully scanned.The common ultrasonographic manifestations of TTN were double-lung point (DLP), interstitial syndromes or white lungs, pleural line abnormalities, and A-line disappearance. A small number of infants (20%) with TTN exhibited pleural effusions, whereas the main ultrasonographic manifestation of RDS was lung consolidation with air bronchograms, which does not occur in TTN. The sensitivity and specificity of DLP for the diagnosis of TTN were 76.7% and 100%, respectively. LUS can accurately and reliably diagnose TTN. The DLP and lung consolidation possess great value in the diagnosis and differential diagnosis of TTN with RDS. Thus, we believe that LUS can be widely used in neonatal intensive care units.
authors.affiliation: From the Department of Neonatology and NICU of Bayi Children's Hospital (JL, YW, WF, C-SY, J-JH), Beijing Military General Hospital, Beijing; and Graduate School of Southern Medical University (YW, WF), Guangzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Fu
authors.forename: Chang-Shuan
authors.initials: CS
authors.lastname: Yang
authors.forename: Jun-Jin
authors.initials: JJ
authors.lastname: Huang
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D059245:Transient Tachypnea of the Newborn / Q000000981:diagnostic imaging*; D014463:Ultrasonography