RT Journal Article
SR Electronic
T1 Lung ultrasound immediately after birth to describe normal neonatal transition: an observational study
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F157
OP F162
DO 10.1136/archdischild-2017-312818
VO 103
IS 2
A1 Douglas A Blank
A1 C Omar Farouk Kamlin
A1 Sheryle R Rogerson
A1 Lisa M Fox
A1 Laila Lorenz
A1 Stefan Charles Kane
A1 Graeme R Polglase
A1 Stuart B Hooper
A1 Peter G Davis
YR 2018
UL http://fn.bmj.com/content/103/2/F157.abstract
AB Objective Lung ultrasound (LUS) has shown promise as a diagnostic tool for the evaluation of the newborn with respiratory distress. No study has described LUS during ‘normal’ transition. Our goal was to characterise the appearance of serial LUS in healthy newborns from the first minutes after birth until airway liquid clearance is achieved.Study design Prospective observational study.Setting Single-centre tertiary perinatal centre in Australia.Patients Of 115 infants born at ≥35 weeks gestational age, mean (SD) gestational age of 386/7 weeks±11 days, mean birth weight of 3380±555 g, 51 were delivered vaginally, 14 via caesarean section (CS) after labour and 50 infants via elective CS.Interventions We obtained serial LUS videos via the right and left axillae at 1–10 min, 11–20 min and 1, 2, 4 and 24 hours after birth.Main outcome measures LUS videos were graded for aeration and liquid clearance according to a previously validated system.Results We analysed 1168 LUS video recordings. As assessed by LUS, lung aeration and airway liquid clearance occurred quickly. All infants had an established pleural line at the first examination (median=2 (1–4) min). Only 14% of infants had substantial liquid retention at 10 min after birth. 49%, 78% and 100% of infants had completed airway liquid clearance at 2, 4 and 24 hours, respectively.Conclusions In healthy transitioning newborn infants, lung aeration and partial liquid clearance are achieved on the first minutes after birth with complete liquid clearance typically achieved within the first 4 hours of birth.Trial registration number ANZCT 12615000380594.