The Assessment of the Effectiveness of Ultrasound and Near-Infrared Spectroscopy of the Lungs for the Differential Diagnosis of Transient Tachypnea of Newborns and Congenital Pneumonia in Children over 35⁰ Weeks of Gestation. The Prospective Study

Background. The most common cause of respiratory disorders (RD) in the first hours after birth in children older than 35 weeks of gestation are transient tachypnea of the newborns (TTN) and early neonatal infection, in particular, congenital pneumonia (CP). However, in the first 4 hours of life, there are no reliable methods for diagnosing these diseases. The aim of the study is to evaluate the effectiveness of ultrasound (US) and near-infrared spectroscopy (NIRS) of the lungs for the differential diagnosis of TTN and CP in children older than 35 weeks of gestation. Methods. A prospective single-center cohort study based on the Yekaterinburg Clinical Perinatal Center. Newborns older than 35 weeks of gestation with the development of RD in the first 4 hours of life were included, the sample size was 200 children. Upon admission to NICU, he performed studies: US and NIRS of the lungs on the lateral and posterior surfaces of the chest on both sides. A comparative analysis of the score of lung US and NIRS indicators in patients with TTN and CP was carried out. Results. During the study and subsequent analysis of the results, it was revealed that the studied methods for the differential diagnosis of TTN and CP have sensitivity and specificity, respectively: only US of the lungs 75.9% and 57.0%; only lung NIRS 77.6% and 74.6%; US and lung NIRS 86.2% and 84.5% together, the area under the curve 0.898, 95% CI 0.854–0.943, р < 0,001. There is also evidence that the pattern of consolidation in the lungs is significantly more often recorded by US at VP (р < 0,001). Conclusion. The study showed that the combined usage of US and lung NIRS has high sensitivity and specificity for the differential diagnosis of TTN and CP and is a promising method for early diagnosis of these diseases.

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