Background and Aim: Discordant results that demand clarification have been published on diagnostic lung ultrasound (LUS) signs of transient tachypnea of the neonate (TTN) in previous cross-sectional, single-center studies. This work was conducted to correlate clinical and imaging data in a longitudinal and multicenter fashion. Methods: Neonates with a gestational age of 34–40 weeks and presenting with TTN underwent a first LUS scan at 60–180 min of life. LUS scans were repeated every 6–12 h if signs of respiratory distress persisted. Images were qualitatively described and a LUS aeration score was calculated. Clinical data were collected during respiratory distress. Results: We enrolled 65 TTN patients. Thirty-one (47.6%) had a sharp echogenicity increase in the lower lung fields (the “double lung point” or DLP sign). On admission, there was no significant difference between patients with and without DLP in Silverman scores (4 ± 1.5 vs. 4 ± 2.1; p = 0.9) or LUS scores (7.6 ± 2.6 vs. 5.6 ± 3.8; p = 0.12); PaO2/FiO2 (249 ± 93 vs. 252 ± 125; p = 0.91). All initial LUS scans (performed at the onset of distress) and 99.5% of all scans showed a regular pleural line with no consolidation, with only 1 neonate showing consolidation in the follow-up scans. The Silverman and LUS scores were significantly correlated (rho = 0.27; p = 0.02). Conclusion: A regular pleural line with no consolidation is a consistent finding in TTN. The presence of a DLP is not essential for the LUS diagnosis of TTN. A semi-quantitative LUS score correlates well with the clinical course and could be useful in monitoring changes in lung aeration during TTN.

1.
Avery
ME
,
Gatewood
OB
,
Brumley
G
.
Transient tachypnea of newborn. Possible delayed resorption of fluid at birth
.
Am J Dis Child
.
1966
Apr
;
111
(
4
):
380
5
.
[PubMed]
0002-922X
2.
Martin
RJ
,
Koh
N
. A Pulmonary Hemorrhage, Transient Tachypnea and Neonatal Pneumonia In: Buonocore G., Bracci R. Weindling M. (eds) Neonatology. A practical approach to neonatal diseases. Springer Verlag
2012
455-459.
3.
Raimondi
F
,
Cattarossi
L
,
Copetti
R
.
Point-of-Care Chest Ultrasound in the Neonatal Intensive Care Unit: an Italian Perspective
.
Neoreviews
.
2014
;
15
(
1
):
e2
4
. 1526-9906
4.
Copetti
R
,
Cattarossi
L
.
The ‘double lung point’: an ultrasound sign diagnostic of transient tachypnea of the newborn
.
Neonatology
.
2007
;
91
(
3
):
203
9
.
[PubMed]
1661-7800
5.
Kurepa
D
,
Zaghloul
N
,
Watkins
L
,
Liu
J
.
Neonatal lung ultrasound exam guidelines
.
J Perinatol
.
2018
Jan
;
38
(
1
):
11
22
.
[PubMed]
0743-8346
6.
Liu
J
,
Chen
XX
,
Li
XW
,
Chen
SW
,
Wang
Y
,
Fu
W
.
Lung Ultrasonography to Diagnose Transient Tachypnea of the Newborn
.
Chest
.
2016
May
;
149
(
5
):
1269
75
.
[PubMed]
0012-3692
7.
Vergine
M
,
Copetti
R
,
Brusa
G
,
Cattarossi
L
.
Lung ultrasound accuracy in respiratory distress syndrome and transient tachypnea of the newborn
.
Neonatology
.
2014
;
106
(
2
):
87
93
.
[PubMed]
1661-7800
8.
De Luca
D
,
Baroni
S
,
Vento
G
,
Piastra
M
,
Pietrini
D
,
Romitelli
F
, et al.
Secretory phospholipase A2 and neonatal respiratory distress: pilot study on broncho-alveolar lavage
.
Intensive Care Med
.
2008
Oct
;
34
(
10
):
1858
64
.
[PubMed]
0342-4642
9.
Been
JV
,
Vanterpool
SF
,
de Rooij
JD
,
Rours
GI
,
Kornelisse
RF
,
van Dongen
MC
, et al.
A clinical prediction rule for histological chorioamnionitis in preterm newborns
.
PLoS One
.
2012
;
7
(
10
):
e46217
.
[PubMed]
1932-6203
10.
De Luca
D
,
van Kaam
AH
,
Tingay
DG
,
Courtney
SE
,
Danhaive
O
,
Carnielli
VP
, et al.
The Montreux definition of neonatal ARDS: biological and clinical background behind the description of a new entity
.
Lancet Respir Med
.
2017
Aug
;
5
(
8
):
657
66
.
[PubMed]
2213-2600
11.
Sweet
DG
,
Carnielli
V
,
Greisen
G
,
Hallman
M
,
Ozek
E
,
Plavka
R
, et al.
European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2016 Update
.
Neonatology
.
2017
;
111
(
2
):
107
25
.
[PubMed]
1661-7800
12.
Gizzi
C
,
Klifa
R
,
Pattumelli
MG
,
Massenzi
L
,
Taveira
M
,
Shankar-Aguilera
S
, et al.
Continuous Positive Airway Pressure and the Burden of Care for Transient Tachypnea of the Neonate: Retrospective Cohort Study
.
Am J Perinatol
.
2015
Aug
;
32
(
10
):
939
43
.
[PubMed]
0735-1631
13.
Brat
R
,
Yousef
N
,
Klifa
R
,
Reynaud
S
,
Shankar Aguilera
S
,
De Luca
D
.
Lung Ultrasonography Score to Evaluate Oxygenation and Surfactant Need in Neonates Treated With Continuous Positive Airway Pressure
.
JAMA Pediatr
.
2015
Aug
;
169
(
8
):
e151797
.
[PubMed]
2168-6203
14.
Restrepo
RD
,
Hirst
KR
,
Wittnebel
L
,
Wettstein
R
.
AARC clinical practice guideline: transcutaneous monitoring of carbon dioxide and oxygen: 2012
.
Respir Care
.
2012
Nov
;
57
(
11
):
1955
62
.
[PubMed]
0020-1324
15.
Machado
LU
,
Fiori
HH
,
Baldisserotto
M
,
Ramos Garcia
PC
,
Vieira
AC
,
Fiori
RM
.
Surfactant deficiency in transient tachypnea of the newborn
.
J Pediatr
.
2011
Nov
;
159
(
5
):
750
4
.
[PubMed]
0022-3476
16.
Liu
J
,
Wang
Y
,
Fu
W
,
Yang
CS
,
Huang
JJ
.
Diagnosis of neonatal transient tachypnea and its differentiation from respiratory distress syndrome using lung ultrasound
.
Medicine (Baltimore)
.
2014
Dec
;
93
(
27
):
e197
.
[PubMed]
0025-7974
17.
Chen
SW
,
Fu
W
,
Liu
J
,
Wang
Y
.
Routine application of lung ultrasonography in the neonatal intensive care unit
.
Medicine (Baltimore)
.
2017
Jan
;
96
(
2
):
e5826
.
[PubMed]
0025-7974
18.
Rachuri
H
,
Oleti
TP
,
Murki
S
,
Subramanian
S
,
Nethagani
J
.
Diagnostic Performance of Point of Care Ultrasonography in Identifying the Etiology of Respiratory Distress in Neonates
.
Indian J Pediatr
.
2017
Apr
;
84
(
4
):
267
70
.
[PubMed]
0019-5456
19.
Raimondi
F
,
Migliaro
F
,
De Luca
D
,
Yousef
N
,
Rodriguez Fanjul
J
.
Clinical Data Are Essential to Validate Lung Ultrasound
.
Chest
.
2016
Jun
;
149
(
6
):
1575
.
[PubMed]
0012-3692
20.
Liu
J
,
Chen
SW
,
Liu
F
,
Li
QP
,
Kong
XY
,
Feng
ZC
.
The diagnosis of neonatal pulmonary atelectasis using lung ultrasonography
.
Chest
.
2015
Apr
;
147
(
4
):
1013
9
.
[PubMed]
0012-3692
21.
Piastra
M
,
Yousef
N
,
Brat
R
,
Manzoni
P
,
Mokhtari
M
,
De Luca
D
.
Lung ultrasound findings in meconium aspiration syndrome
.
Early Hum Dev
.
2014
Sep
;
90
Suppl 2
:
S41
3
.
[PubMed]
0378-3782
22.
Copetti
R
,
Cattarossi
L
,
Macagno
F
,
Violino
M
,
Furlan
R
.
Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis
.
Neonatology
.
2008
;
94
(
1
):
52
9
.
[PubMed]
1661-7800
23.
Hiles
M
,
Culpan
AM
,
Watts
C
,
Munyombwe
T
,
Wolstenhulme
S
.
Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis
.
Ultrasound
.
2017
;
25
:
80
9
.
[PubMed]
1742-271X
24.
Autilio
C
,
Echaide
M
,
Benachi
A
,
Marfaing-Koka
A
,
Capoluongo
ED
,
Pérez-Gil
J
, et al.
A Noninvasive Surfactant Adsorption Test Predicting the Need for Surfactant Therapy in Preterm Infants Treated with Continuous Positive Airway Pressure
.
J Pediatr
.
2017
Mar
;
182
:
66
73.e1
.
[PubMed]
0022-3476
25.
Veeramani
SK
,
Muthusamy
E
.
Detection of abnormalities in ultrasound lung image using multi-level RVM classification
.
J Matern Fetal Neonatal Med
.
2016
;
29
(
11
):
1844
52
.
[PubMed]
1476-4954
26.
Escourrou
G
,
De Luca
D
.
Lung ultrasound decreased radiation exposure in preterm infants in a neonatal intensive care unit
.
Acta Paediatr
.
2016
May
;
105
(
5
):
e237
9
.
[PubMed]
0803-5253
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.