Bol Med Hosp Infant Mex. 2025;82(Supl 5):61-69. doi: 10.24875/BMHIM.25000087.
ABSTRACT
BACKGROUND: Respiratory viruses are a frequent cause of infection in neonatology. Point-of-care lung ultrasound (LU) and targeted neonatal echocardiography (TnE) allow pulmonary and hemodynamic assessment at the patient's bedside.
METHODS: The aim of this study was to describe the pattern of alterations found by LU and to assess the hemodynamic status in neonates diagnosed with viral infection (reverse transcription polymerase chain reaction) during 2018-2023. LU was performed in 10 regions, and a semi-quantitative scale LU score (LUS) was calculated. TnE was performed if pulmonary hypertension (PH) was sus-pected. The thymus was measured by ultrasound if there was evidence of increased dimensions on chest X-ray or during LU.
RESULTS: Forty-seven patients were studied (35 severe acute respiratory syndrome coronavirus 2, four respiratory syncytial virus, four rhinovirus, three influenza, and one parainfluenza). LU showed an interstitial pattern of B-lines in 94%, pleural line anomalies in 85%, coalescing B-lines in 60%, and consolidations in 51% (71% posteriorly). About 30% had PH. An increased thymus was shown in 23%. LUS showed a significant median difference between ventilatory support and a positive correlation with FiO2 used. Consolidations and the presence of PH were associated with mortality; an increased thymus was shown protective.
CONCLUSION: Ultrasound at the patient's bedside allows the classification and detection of the seriously ill patient (presence of consolidations and PH) allowing timely intervention. As a clinical finding, an increased thymus was shown to be a protective factor against mortality and could represent a marker of adequate immune response.
PMID:41401434 | DOI:10.24875/BMHIM.25000087