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Am J Perinatol 2022; 39(09): 0973-0979
DOI: 10.1055/s-0040-1721134
Original Article

Accuracy and Reliability of Lung Ultrasound to Diagnose Transient Tachypnoea of the Newborn: Evidence from a Meta-analysis and Systematic Review

Hai-Ran Ma 
1   Department of Neonatology and Neonatal Intensive Care Unit, Huizhou Municipal Central Hospital, Huizhou Guangdong, Republic of China
2   Department of Neonatology and Neonatal Intensive Care Unit, Beijing Chaoyang District Maternal and Child Healthcare Hospital, Beijing and National Neonatal Lung Ultrasound Training Center, Beijing, Republic of China
,
Jing Liu 
2   Department of Neonatology and Neonatal Intensive Care Unit, Beijing Chaoyang District Maternal and Child Healthcare Hospital, Beijing and National Neonatal Lung Ultrasound Training Center, Beijing, Republic of China
,
Wen-Kang Yan
1   Department of Neonatology and Neonatal Intensive Care Unit, Huizhou Municipal Central Hospital, Huizhou Guangdong, Republic of China
› Author Affiliations Funding This work was supported by the Social Development Projects, Beijing Chaoyang District Bureau of Science, Technology and Information (grant no. CYSF1922).
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Abstract

Objective Transient tachypnoea of the newborn (TTN) is one of the most common causes of neonatal respiratory distress (RD) during the newborn period. Chest radiography (CXR) is commonly used to rule out the diagnosis, but TTN is often misdiagnosed as neonatal respiratory distress syndrome (NRDS) on the basis of CXR alone. Increasing evidence suggests that lung ultrasound (LUS) may be a reliable diagnostic tool for transient tachypnoea of the newborn. However, studies of the diagnostic efficiency of LUS are still lacking. This study was aimed to evaluate the accuracy and reliability of LUS for diagnosing TTN by conducting a systematic review and meta-analysis.

Study Design We searched for articles in the Embase, PubMed, and Cochrane Library databases from inception until May 31, 2020. The selected studies were diagnostic accuracy studies that reported the utility of LUS in the diagnosis of TTN. Two researchers independently extracted data and assessed quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Then, we created a bivariate model of mixed effects to calculate the sensitivity and specificity of LUS in diagnosing TTN. A summary receiver operator characteristic (SROC) curve was constructed to summarize the performance characteristics of LUS.

Results Six studies involving 617 newborns were included in the review. LUS had a pooled sensitivity of 0.98 (confidence interval [CI]: 0.92–1.00) and a specificity of 0.99 (CI: 0.91–1.00). The area under the curve for LUS was 1.00 (0.98–1.0). Meta-regression revealed that LUS had a significant diagnostic accuracy for TTN.

Conclusion The performance of ultrasound for the detection of TTN was excellent. Considering the various advantages of LUS compared with chest radiographs in diagnosing TTN, this study supports the routine use of LUS for the detection of TTN.

Key Points

  • Lung ultrasound is a highly accurate diagnostic tool, which may be a viable and superior alternative to CXR, in diagnosing TTN.

  • Lung ultrasound can help differentiate TTN from other etiologies of respiratory distress in neonates.

  • There are still some controversies on the ultrasound diagnostic criteria of TTN.

Keywords

ultrasonography - transient tachypnoea of the newborn - newborn

Authors' Contributions

H.R.M. and J.L. contributed to the study design, literature search and data extraction, methodologic quality assessment. H.R.M. conducted statistical analysis and drafted the manuscript. J.L. revised the manuscript and supervised the study. W.K.Y. double-checked the integrity of data and the accuracy of data analysis. All authors approved the final version of this research.




Publication History

Received: 18 July 2020

Accepted: 16 October 2020

Article published online:
26 November 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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