Link: https://www.ncbi.nlm.nih.gov/pubmed/30666398

Eur J Pediatr. 2019 Jan 21. doi: 10.1007/s00431-019-03321-y. [Epub ahead of print]
Lung ultrasound findings in congenital diaphragmatic hernia.
Corsini I1, Parri N2, Coviello C3, Leonardi V3, Dani C3,4.
Author information
Abstract
Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 2500 to 5000 infants. The use of lung ultrasound (LUS) for its diagnosis has been reported in only two case reports. The aim of this study was to report the LUS pattern of CDH in a case series of infants with respiratory distress. This case series was part of a cohort enrolled in a larger prospective observational study. LUS was performed at the point-of-care during the first 24 h of life of the neonates and its operation time was measured. Seven cases (six left and one right CDH) were diagnosed. We found that the pattern of LUS for CDH diagnosis includes (1) partial absence of the hyperechoic line representing the normal diaphragmatic profile, (2) partial absence of the pleural line in the affected hemithorax, (3) absence of A lines in the affected area, (4) presence of multi-layered area with hyperechoic contents in motion (normal gut), and (5) possible presence of parenchymatous organs inside the thorax (i.e., liver or spleen).Conclusion: A description of LUS pattern in infants with CDH is provided. LUS at the point-of-care may allow the prompt diagnosis of CDH and this is particularly useful in cases of missed prenatal diagnosis. What is Known: Congenital diaphragmatic hernia occurs in approximately 1 in 2500 to 5000 infants but the use of lung ultrasound for its diagnosis has been reported in only two case reports. What is New: Research provided a description of lung ultrasound pattern in infants with congenital diaphragmatic hernia. Lung ultrasound at the point-of-care may allow a prompt diagnosis of congenital diaphragmatic hernia, particularly useful in cases of missed prenatal diagnosis.

KEYWORDS:
Congenital diaphragmatic hernia; Intensive care; Lung ultrasound; Neonate

PMID: 30666398 DOI: 10.1007/s00431-019-03321-y
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