Point-of-Care Ultrasound versus Chest X-Ray for Determining Lung Expansion Based on Rib Count in High-Frequency Oscillatory Ventilation

Neonatology. 2023;120(6):736-740. doi: 10.1159/000533318. Epub 2023 Aug 25.

Abstract

Introduction: Chest X-ray (CXR) is the most prevalent method for evaluating lung expansion in high-frequency oscillatory ventilation (HFOV). The purpose of this study was to compare the accuracy of chest radiography with point-of-care ultrasound (POCUS) in determining lung expansion.

Methods: This prospective study included newborns who required HFOV and were monitored in a neonatal intensive care unit. A single neonatologist assessed lung expansion with CXR and POCUS to measure the costal level of the right hemidiaphragm and compared the results.

Results: A neonatologist performed 55 measurements in 28 newborns with a gestational age of 32 (23.2-39.4) weeks, followed by HFOV. The rib counts obtained from anterior chest ultrasonography and posterior CXR showed a statistically high concordance (r = 0.913, p < 0.001).

Conclusion: Lung ultrasonography is a reliable method for the evaluation of lung expansion based on rib count in patients with HFOV.

Keywords: High-frequency oscillatory ventilation; Lung ultrasonography; Newborn; Optimal lung expansion.

MeSH terms

  • High-Frequency Ventilation*
  • Humans
  • Infant
  • Infant, Newborn
  • Lung / diagnostic imaging
  • Point-of-Care Systems
  • Prospective Studies
  • Radiography
  • Respiratory Distress Syndrome, Newborn*
  • Ribs / diagnostic imaging
  • Ultrasonography
  • X-Rays