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Alonso-Ojembarrena A, Gregorio-Hernández R, Raimondi F. Neonatal point-of-care lung ultrasound: what should be known and done out of the NICU? Eur J Pediatr 2024; 183:1555-1565. [PMID: 38315204 DOI: 10.1007/s00431-023-05375-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 02/07/2024]
Abstract
Lung ultrasound is rapidly becoming a useful tool in the care of neonates: its ease of use, reproducibility, low cost, and negligible side effects make it a very suitable tool for the respiratory care of all neonates. This technique has been extensively studied by different approaches in neonatal intensive care unit (NICU), both for diagnostic and prognostic aims and to guide respiratory treatments. However, many neonates are being born in level I/II hospitals without NICU facilities so all pediatricians, not just neonatal intensivists, should be aware of its potential. This is made possible by the increasing access to ultrasound machines in a modern hospital setting. In this review, we describe the ultrasonographic characteristics of the normal neonatal lung. We also discuss the ultrasound features of main neonatal respiratory diseases: transient tachypnea of the neonate (TTN), respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), pneumothorax (PNX), pleural effusion (PE), or pneumonia. Finally, we mention two functional approaches to lung ultrasound: 1. The use of lung ultrasound in level I delivery centers as a mean to assess the severity of neonatal respiratory distress and request a transport to a higher degree structure in a timely fashion. 2. The prognostic accuracy of lung ultrasound for early and targeted surfactant replacement. CONCLUSION LU is still a useful tool in level I/II neonatal units, both for diagnostic and functional issues. WHAT IS KNOWN • Neonatal lung ultrasound has been recently introduced in the usual care in many Neonatal Intensive Care Units. WHAT IS NEW • It also has many advantages in level I/II neonatal units, both for neonatologist or even pediatricians that treat neonates in those sites.
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Affiliation(s)
- Almudena Alonso-Ojembarrena
- Neonatal Intensive Care Unit, Puerta del Mar University Hospital, Avenida Ana de Viya, 11, 11009, Cádiz, Spain.
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain.
| | | | - Francesco Raimondi
- Division of Neonatology, Department of Translational Medical Sciences, Università Federico II Di Napoli, Naples, Italy
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Gregorio-Hernández R, Sánchez-Luna M. Reply to: Lung ultrasound in neonates with congenital diaphragmatic hernia and the need for a quantitative evaluation. Eur J Pediatr 2023; 182:5715-5716. [PMID: 37847264 DOI: 10.1007/s00431-023-05256-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Affiliation(s)
- R Gregorio-Hernández
- Neonatology Department, Gregorio Marañón Hospital, O'Donnell 48 street, 28009, Madrid, Spain.
| | - M Sánchez-Luna
- Neonatology Department, Gregorio Marañón Hospital, O'Donnell 48 street, 28009, Madrid, Spain
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Corsini I, Rodriguez-Fanjul J, Raimondi F, Boni L, Berardi A, Aldecoa-Bilbao V, Alonso-Ojembarrena A, Ancora G, Aversa S, Beghini R, Meseguer NB, Capasso L, Chesi F, Ciarcià M, Concheiro A, Corvaglia L, Ficial B, Filippi L, Carballal JF, Fusco M, Gatto S, Ginovart G, Gregorio-Hernández R, Lista G, Sánchez-Luna M, Martini S, Massenzi L, Miselli F, Mercadante D, Mosca F, Palacio MT, Perri A, Piano F, Prieto MP, Fernandez LR, Risso FM, Savoia M, Staffler A, Vento G, Dani C. Lung UltrasouNd Guided surfactant therapy in preterm infants: an international multicenter randomized control trial (LUNG study). Trials 2023; 24:706. [PMID: 37925512 PMCID: PMC10625281 DOI: 10.1186/s13063-023-07745-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The management of respiratory distress syndrome (RDS) in premature newborns is based on different types of non-invasive respiratory support and on surfactant replacement therapy (SRT) to avoid mechanical ventilation as it may eventually result in lung damage. European guidelines currently recommend SRT only when the fraction of inspired oxygen (FiO2) exceeds 0.30. The literature describes that early SRT decreases the risk of bronchopulmonary dysplasia (BPD) and mortality. Lung ultrasound score (LUS) in preterm infants affected by RDS has proven to be able to predict the need for SRT and different single-center studies have shown that LUS may increase the proportion of infants that received early SRT. Therefore, the aim of this study is to determine if the use of LUS as a decision tool for SRT in preterm infants affected by RDS allows for the reduction of the incidence of BPD or death in the study group. METHODS/DESIGN In this study, 668 spontaneously-breathing preterm infants, born at 25+0 to 29+6 weeks' gestation, in nasal continuous positive airway pressure (nCPAP) will be randomized to receive SRT only when the FiO2 cut-off exceeds 0.3 (control group) or if the LUS score is higher than 8 or the FiO2 requirements exceed 0.3 (study group) (334 infants per arm). The primary outcome will be the difference in proportion of infants with BPD or death in the study group managed compared to the control group. DISCUSSION Based on previous published studies, it seems that LUS may decrease the time to administer surfactant therapy. It is known that early surfactant administration decreases BPD and mortality. Therefore, there is rationale for hypothesizing a reduction in BPD or death in the group of patients in which the decision to administer exogenous surfactant is based on lung ultrasound scores. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT05198375 . Registered on 20 January 2022.
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Affiliation(s)
- Iuri Corsini
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, 50134, Florence, Italy.
| | | | - Francesco Raimondi
- Division of Neonatology, Federico II University of Naples, Naples, Italy
| | - Luca Boni
- SC Epidemiologia Clinica IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alberto Berardi
- Neonatal Intensive Care Unit, Policlinico Universitario Modena, Modena, Italy
| | - Victoria Aldecoa-Bilbao
- Neonatal Intensive Care Unit, Hospital Clínic Barcelona, BCNatal (Barcelona Center for Maternal Fetal and Neonatal Medicine), Barcelona, Spain
| | | | - Gina Ancora
- Neonatal Intensive Care Unit, Ospedale Infermi Di Rimini, Rimini, Italy
| | - Salvatore Aversa
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Renzo Beghini
- Neonatal Intensive Care Unit, AOUI Verona, Verona, Italy
| | | | - Letizia Capasso
- Division of Neonatology, Federico II University of Naples, Naples, Italy
| | - Francesca Chesi
- Neonatal Intensive Care Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Martina Ciarcià
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Ana Concheiro
- Neonatal Intensive Care Unit, Hospital Alvaro Cunqueiro, Vigo, Spain
| | - Luigi Corvaglia
- Neonatal Intensive Care Unit IRCCS AUOBO, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Luca Filippi
- Neonatal Intensive Care Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jesus Fuentes Carballal
- Neonatal Intensive Care Unit, Complexo Hospitalario Universitario de A Coruña (CHUAC), Coruña, Spain
| | - Monica Fusco
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, 50134, Florence, Italy
| | - Sara Gatto
- Neonatal Intensive Care Unit, Ospedale Dei Bambini "V.Buzzi", Milan, Italy
| | - Gemma Ginovart
- Neonatal Intensive Care Unit. Hospital Germans Trias I Pujol, Badalona, Spain
| | | | - Gianluca Lista
- Neonatal Intensive Care Unit, Ospedale Dei Bambini "V.Buzzi", Milan, Italy
| | | | - Silvia Martini
- Neonatal Intensive Care Unit IRCCS AUOBO, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Francesca Miselli
- Neonatal Intensive Care Unit, Policlinico Universitario Modena, Modena, Italy
| | - Domenica Mercadante
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Marta Teresa Palacio
- Neonatal Intensive Care Unit, Hospital Clínic Barcelona, BCNatal (Barcelona Center for Maternal Fetal and Neonatal Medicine), Barcelona, Spain
| | | | - Francesca Piano
- Neonatal Intensive Care Unit, Ospedale Infermi Di Rimini, Rimini, Italy
| | | | | | - Francesco Maria Risso
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | | | | | - Giovanni Vento
- Neonatal Intensive Care Unit, Policlinico Gemelli, Rome, Italy
| | - Carlo Dani
- Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla 3, 50134, Florence, Italy
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Gregorio-Hernández R, Ramos-Navarro C, Vigil-Vázquez S, Rodríguez-Corrales E, Pérez-Pérez A, Arriaga-Redondo M, Sánchez-Luna M. Lung ultrasound and postoperative follow-up of congenital diaphragmatic hernia. Eur J Pediatr 2023; 182:3973-3981. [PMID: 37368006 DOI: 10.1007/s00431-023-05074-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
Lung ultrasound (LU) has emerged as a valuable tool for assessing pulmonary aeration noninvasively, rapidly, and reliably in different neonatal conditions. However, its role in the preoperative and postoperative evaluation in congenital diaphragmatic hernia (CDH) is still poorly analyzed. We present a cohort of 8 patients diagnosed with CDH who underwent lung ultrasound examinations at various time points before and after surgical correction. The lung ultrasound patterns were compared between two groups: mechanical ventilation ≤ 7 days (MV ≤ 7) and mechanical ventilation > 7 days (MV > 7). The ultrasound findings were also compared to CT scans and chest X-ray images to assess its diagnostic capacity for identifying postoperative complications: pneumothorax, pleural effusion, and pneumonia. Group MV ≤ 7 exhibited a normal pattern even at 48 h postsurgery, while group MV > 7 presented interstitial or alveolointerstitial pattern in both lungs for prolonged periods (2-3 weeks). Furthermore, contralateral LU pattern may be predictive of respiratory evolution. Conclusion: Lung ultrasound is a valuable tool for evaluating the progressive reaeration of the lung following surgical correction in CDH patients. It demonstrates the ability to diagnose common postoperative complications without the need for radiation exposure while offering the advantages of quick and serial assessments. These findings highlight the potential of lung ultrasound as an effective alternative to conventional imaging methods in the management of CDH. What is Known: • Lung ultrasound evaluates lung aeration and predicts respiratory outcomes in neonatal patients. What is New: • Lung ultrasound is useful in the postsurgical management of congenital diaphragmatic hernia patients, detecting reaeration and respiratory complications.
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Affiliation(s)
| | - C Ramos-Navarro
- Neonatology Department, Gregorio Marañón Hospital, Madrid, Spain
| | - S Vigil-Vázquez
- Neonatology Department, Gregorio Marañón Hospital, Madrid, Spain
| | | | - A Pérez-Pérez
- Neonatology Department, Gregorio Marañón Hospital, Madrid, Spain
| | | | - M Sánchez-Luna
- Neonatology Department, Gregorio Marañón Hospital, Madrid, Spain
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Gregorio-Hernández R, Chimenti-Camacho P, Aguado Del Hoyo A, Sánchez-Luna M. A case of neonatal tuberous sclerosis diagnosed by lung ultrasound. An Pediatr (Barc) 2023:S2341-2879(23)00127-8. [PMID: 37301683 DOI: 10.1016/j.anpede.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/14/2023] [Indexed: 06/12/2023] Open
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6
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Gregorio-Hernández R, Chimenti-Camacho P, Aguado del Hoyo A, Sánchez-Luna M. Esclerosis tuberosa diagnosticada por ecografía torácica POCUS. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
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Alonso-Ojembarrena A, Montero-Gato J, Gregorio-Hernández R, Aldecoa-Bilbao V, Alonso-Quintela P, Rodriguez-Fanjul J, Concheiro-Guisán A, Trujillo-Fagundo A, García-Ojanguren AM, de Las Heras-Martín M, Pérez-Pérez A, Teresa-Palacio M, Durán-Fernández-Feijóo C, Morales-Arandojo P, Pumarada-Prieto M, Oulego-Erroz I. Lung Ultrasound Scores Progress Differently in Extreme and Very Preterm Infants after Birth: A Multicentre Prospective Study. Neonatology 2022; 119:558-566. [PMID: 35793660 DOI: 10.1159/000525187] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/18/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The lung ultrasound score (LUS) has been suggested to predict moderate-severe bronchopulmonary dysplasia (msBPD) in preterm infants. We aimed to assess LUS evolution after birth in preterm infants and the effect of gestational age. METHODS This multicentre prospective observational study was performed with newborns born before 33 weeks of gestation. We created two groups: group 1 (23-27 weeks) and group 2 (28-32 weeks). We compared LUSs between the groups from birth until 36 weeks of postmenstrual age, and we estimated the LUS evolution in each group with a linear multilevel mixed-effects regression model. The effects of the need for surfactant or an msBPD diagnosis were also studied. RESULTS We included 339 patients: 122 (36%) in group 1 and 217 (64%) in group 2. The infants in group 1 showed a steady progression in the LUS from birth until 4 weeks of age and a subsequent decrease; the infants in group 2 showed a progressive decrease in the LUS throughout the study. This progression varied significantly in the first weeks of life in infants who required surfactant at birth and after the first week of life in the patients diagnosed with msBPD. DISCUSSION/CONCLUSIONS Extremely preterm infants showed persistently high LUSs during the first weeks of life, regardless of the progression to msBPD. In this group, the infants who did not require surfactant at birth exhibited an increase in their LUSs after the first week until their values were equal to the remaining infants in their group.
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Affiliation(s)
- Almudena Alonso-Ojembarrena
- Neonatal Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
| | - Jon Montero-Gato
- Neonatal Intensive Care Unit, Basurto University Hospital, Bilbao, Spain
| | | | - Victoria Aldecoa-Bilbao
- Neonatology Department, Hospital Clínic Barcelona, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Barcelona, Spain
| | - Paula Alonso-Quintela
- Neonatal Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain
- Biomedicine Institute of León (IBIOMED), University of León, León, Spain
| | | | - Ana Concheiro-Guisán
- Neonatal Intensive Care Unit, Alvaro Cunqueiro Hospital, Vigo, Spain
- Sanitary investigation institute Galicia Sur (IIS Galicia Sur), Vigo, Spain
| | - Alberto Trujillo-Fagundo
- Neonatal and Pediatric Intensive Care Unit, Doctor Josep Trueta University Hospital, Girona, Spain
| | | | | | - Alba Pérez-Pérez
- Neonatal Intensive Care Unit, Gregorio Marañón University Hospital, Madrid, Spain
| | - Marta Teresa-Palacio
- Neonatology Department, Hospital Clínic Barcelona, BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Barcelona, Spain
| | - Cristina Durán-Fernández-Feijóo
- Neonatal Intensive Care Unit, Alvaro Cunqueiro Hospital, Vigo, Spain
- Sanitary investigation institute Galicia Sur (IIS Galicia Sur), Vigo, Spain
| | | | - Marcelino Pumarada-Prieto
- Neonatal Intensive Care Unit, Alvaro Cunqueiro Hospital, Vigo, Spain
- Sanitary investigation institute Galicia Sur (IIS Galicia Sur), Vigo, Spain
| | - Ignacio Oulego-Erroz
- Biomedicine Institute of León (IBIOMED), University of León, León, Spain
- Pediatric Intensive Care Unit, Complejo Asistencial Universitario de León, León, Spain
- Working Group on Bedside Ultrasound of the Spanish Society of Pediatric Intensive Care (SECIP), Madrid, Spain
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Gregorio-Hernández R, Pérez-Pérez A, Alonso-Ojembarrena A, Arriaga-Redondo M, Ramos-Navarro C, Sánchez-Luna M. Neonatal pneumothoraces with atypical location: the role of lung ultrasound. Eur J Pediatr 2022; 181:1751-1756. [PMID: 34845527 DOI: 10.1007/s00431-021-04329-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 01/02/2023]
Abstract
UNLABELLED Neonatal pneumothorax (NP) is a potentially life-threatening condition. Lung ultrasound (LUS) has shown higher sensitivity and specificity in diagnosis compared to x-rays, but evidence regarding its usefulness in complex NP is lacking. We report four neonates suffering from cardiac or esophageal malformations who developed lateral and/or posterior pneumothoraces, in which LUS helped, making NP diagnosis and management easier and faster. CONCLUSION LUS is an easy-to-use, fast, simple, and accurate tool when evaluating newborns with NP, also in atypical positions such as in surgical patients. WHAT IS KNOWN • Lung ultrasound (LUS) has higher sensitivity and specificity than x-rays in the diagnosis of pneumothorax in neonatal patients. WHAT IS NEW • This is the first report about neonatal pneumothorax in non-conventional areas (lateral/posterior) diagnosed by lung ultrasound and how obtaining this information is critical in order to optimize management.
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Affiliation(s)
| | - Alba Pérez-Pérez
- Neonatology Department, Gregorio Marañón University Hospital, Madrid, Spain
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Gregorio-Hernández R, Escobar-Izquierdo AB, Cobas-Pazos J, Martínez-Gimeno A. Point-of-care lung ultrasound in three neonates with COVID-19. Eur J Pediatr 2020; 179:1279-1285. [PMID: 32504135 PMCID: PMC7274567 DOI: 10.1007/s00431-020-03706-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 12/18/2022]
Abstract
Since March 2020, the world is involved in the COVID-19 pandemic, a disease caused by a novel virus called SARS-CoV-2. Some authors have described the ultrasonographic findings of COVID-19 pneumonia in adults and children, but data on neonates are lacking. Our objective was to describe the ultrasonographic lung pattern on newborns with SARS-CoV-2 infection during the COVID-19 pandemic. Newborns who tested positive for SARS-CoV-2 PCR in respiratory samples and were evaluated with point-of-care lung ultrasound (LU) from March to April 2020 were included. LU was performed bedside by a single investigator at the time of diagnosis and every 48 h during the first week following diagnosis. Six areas were studied. Three neonates were included. Infants' comorbidities included meconium aspiration syndrome, bronchopulmonary dysplasia, and Hirschsprung's disease. One required mechanical ventilation. No deaths occurred. LU showed B-lines, consolidation, and spared areas. No pneumothorax or pleural effusion was observedConclusions: LU could be of value when managing COVID-19 neonates. We describe the findings of lung ultrasound monitoring during the first week following diagnosis in three neonates with SARS-CoV-2 infection. What is known: • Lung ultrasound (LU) is a useful tool in COVID-19 management in adults. To date, no report on LU and neonates with SARS-CoV-2 infection has been published. What is new: • This study adds evidence about LU findings in neonates with SARS-CoV-2 infection.
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Affiliation(s)
| | | | - J. Cobas-Pazos
- Neonatology Area, Pediatrics Department, Virgen de la Salud Hospital, Toledo, Spain
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Gregorio-Hernández R, González-Valcarcel M, Escobar-Izquierdo AB, López-Lozano Y, Cabada-Del Río A. Neonatal epidural haematoma. Presentation of 3 cases and a literature review. Anales de Pediatría (English Edition) 2018. [DOI: 10.1016/j.anpede.2017.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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11
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Sobrino-Fernández E, Campos-Domínguez M, Gregorio-Hernández R, Huerta-Aragonés J, Beléndez-Bieler C, Lancharro-Zapata Á, Franco-Fernández ML, Bernardo-Atienza B, Sánchez-Luna M. Kaposiform Hemangioendothelioma Presenting as Hydrops Fetalis. Pediatr Dermatol 2017; 34:e128-e129. [PMID: 28318049 DOI: 10.1111/pde.13101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We describe the case of a 33-week preterm infant who developed nonimmune hydrops fetalis secondary to a kaposiform hemangioendothelioma (KHE). The tumor was successfully treated with vincristine, prednisone, ticlopidine, and aspirin. KHE can be an unusual cause of hydrops fetalis; in such cases, diagnosis can be challenging since generalized edema can obscure KHE.
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Affiliation(s)
- Elena Sobrino-Fernández
- Section of Neonatology, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Minia Campos-Domínguez
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rebeca Gregorio-Hernández
- Section of Neonatology, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Jorge Huerta-Aragonés
- Section of Pediatric Oncology, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Beléndez-Bieler
- Section of Pediatric Oncology, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ángel Lancharro-Zapata
- Section of Pediatric Radiology, Department of Radiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - María Luisa Franco-Fernández
- Section of Neonatology, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Belén Bernardo-Atienza
- Section of Neonatology, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Sánchez-Luna
- Section of Neonatology, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Gregorio-Hernández R, González-Valcarcel M, Escobar-Izquierdo AB, López-Lozano Y, Cabada-Del Río A. [Neonatal epidural haematoma. Presentation of 3 cases and a literature review]. An Pediatr (Barc) 2017; 88:50-51. [PMID: 28256345 DOI: 10.1016/j.anpedi.2017.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/13/2017] [Accepted: 01/17/2017] [Indexed: 11/19/2022] Open
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Gregorio-Hernández R, Sanz-López E, Hoyo AAD, Manrique-Martín G, De-Agustín JC, Sánchez-Luna M. A Rare Complex Case of Congenital Umbilical Arteriovenous Malformation and Review of Literature. AJP Rep 2016; 6:e216-21. [PMID: 27294008 PMCID: PMC4900887 DOI: 10.1055/s-0036-1584239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Congenital umbilical arteriovenous malformations (AVMs) are extremely rare. We present the first case of congenital umbilical AVM with feeding arteries originating not only from abdominal but also from the mammary arteries. Case Report A 34-week gestational age newborn was transferred to our hospital with a supraumbilical murmur. Abdominal Doppler ultrasound (US) showed a large vascular AVM, with multiple feeding arteries and several venous drainage structures to the umbilical vein and also a persistent ductus venosus. She developed signs of heart failure on the 12th day of life. Computed tomography angiogram revealed an umbilical congenital AVM with feeding arteries originating from the external iliac, hypogastric, epigastric, and mammary arteries and a dilated umbilical vein draining the cluster. Also, a patent ductus venosus was observed. At 14 days of life, laparotomy was performed but due to the complexity of the feeding arteries of the AVM, complete exeresis was not performed, but only ligation of these arteries was made, to reduce the surgical risk. Conclusion To our knowledge, this is the first time that no complete excision was made but only ligation of the arteries. The infant was discharged home on postoperative day 14 being asymptomatic. Follow-up Doppler US showed thrombosed vascular structures.
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Affiliation(s)
| | - Ester Sanz-López
- Department of Neonatology, Gregorio Marañón Hospital, Madrid, Spain
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