title: Lung ultrasound accurately detects pneumothorax in a preterm newborn lamb model.
abstract: OBJECTIVE
  Pneumothorax is a common emergency affecting extremely preterm. In adult studies, lung ultrasound has performed better than chest x-ray in the diagnosis of pneumothorax. The purpose of this study was to determine the efficacy of lung ultrasound (LUS) examination to detect pneumothorax using a preterm animal model.
  
  
  METHODS
  This was a prospective, observational study using newborn Border-Leicester lambs at gestational age = 126 days (equivalent to gestational age = 26 weeks in humans) receiving mechanical ventilation from birth to 2 h of life. At the conclusion of the experiment, LUS was performed, the lambs were then euthanised and a post-mortem exam was immediately performed. We used previously published ultrasound techniques to identify pneumothorax. Test characteristics of LUS to detect pneumothorax were calculated, using the post-mortem exam as the 'gold standard' test.
  
  
  RESULTS
  Nine lambs (18 lungs) were examined. Four lambs had a unilateral pneumothorax, all of which were identified by LUS with no false positives.
  
  
  CONCLUSIONS
  This was the first study to use post-mortem findings to test the efficacy of LUS to detect pneumothorax in a newborn animal model. Lung ultrasound accurately detected pneumothorax, verified by post-mortem exam, in premature, newborn lambs.
authors.affiliation: Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia.|The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Blank
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Hooper
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.|Department of Neonatology, Medical University of Graz, Graz, Austria.
authors.forename: Corinna
authors.initials: C
authors.lastname: Binder-Heschl
authors.affiliation: Department of Neonatology, Royal North Shore Hospital and University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Kluckow
authors.affiliation: Centre for Neonatal Research and Education, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Gill
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Domenic A
authors.initials: DA
authors.lastname: LaRosa
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Ishmael M
authors.initials: IM
authors.lastname: Inocencio
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Moxham
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Karyn
authors.initials: K
authors.lastname: Rodgers
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Zahra
authors.affiliation: Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
authors.affiliation: The Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
authors.forename: Graeme R
authors.initials: GR
authors.lastname: Polglase
mesh_terms: D000818:Animals; D001344:Autopsy; D006801:Humans; D008168:Lung; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012756:Sheep; D014463:Ultrasonography
keywords: bubble test; lung aeration; lung injury; post-mortem exam; respiratory distress syndrome