Positional Lung Ultrasound Scoring in Transient and Nontransient Tachypnea of the Newborn

Mallanagouda Madappagouda Patil, Shankargouda Veeranagouda Patil, Rohith Yampati Abstract

Abstract

Background and Aim: Respiratory distress in neonates includes transient tachypnea of the newborn (TTN) and non-TTN condi¬tions such as respiratory distress syndrome (RDS), pneumonia, and meconium aspiration syndrome. Lung ultrasound (LUS), a noninvasive and radiation-free imaging modality, provides real-time dynamic imaging and offers advantages over traditional chest radiography. This study evaluated positional LUS scoring as a diagnostic marker to differentiate fluid-driven lung conditions like TTN from alveolar collapse-driven conditions such as RDS and pneumonia.

Materials and Methods: This prospective study was conducted at a tertiary Neonatal Intensive Care Unit at Bijapur Lingayat District Education Association (Deemed to be University, Karnataka) from September 2022 to March 2024. Neonates pre¬senting with respiratory distress within the first 12 hours of life were included if they fulfilled criteria, including gestational age ≥ 29 weeks and had an indication for respiratory support. LUS was performed at 3 intervals: baseline, postpositional change, and postsustained impact, with scoring based on 6 lung zones to eval¬uate positional effects on respiratory conditions in TTN and non- TTN using a high-frequency ultrasound transducer.

Results: The study involved 74 neonates (TTN, n = 40; non-TTN, n = 34), with a similar gender ratio. LUS scores among neonates with TTN decreased markedly at different follow-up points, from 2.6 ± 2.8 to 1.3 ± 1.4 (P = .01). In contrast, neonates with non-TTN conditions showed a slight, nonsignificant reduction from 3.1 ± 2.4 to 2.5 ± 1.9 across assessments (P > .05).

Conclusion: The results highlight the potential of positional LUS as a valuable bedside tool for assessing neonatal respiratory distress. It helps differentiate fluid dynamics between TTN and non-TTN (RDS) neonates and guides clinical decision-making.