Publications by authors named "Alonso-Ojembarrena A"
Article Synopsis
- Lung ultrasound could be a valuable tool in predicting the severity of lung disease and the need for extended ventilatory support in critically ill children.
- In a study involving 538 children in the ICU, those requiring prolonged mechanical ventilation (over 7 days) had significantly higher lung ultrasound scores at 12 and 48-72 hours post-admission.
- The lung ultrasound score demonstrated a strong correlation with oxygen levels and was effective in predicting prolonged mechanical ventilation, showing high accuracy in both initial assessment and multivariable analysis.
Importance: Surfactant administration may be needed in late preterm through full-term neonates, but the pathophysiology of their respiratory failure can be different from that of early preterm neonates. The lung ultrasonography score (LUS) is accurate to guide surfactant replacement in early preterm neonates, but to our knowledge, it has not yet been studied in the late preterm through full-term neonatal population.
Objective: To assess whether LUS is equally accurate to predict surfactant need in late preterm through full-term neonates as in early preterm neonates.
Article Synopsis
- An international survey was conducted across 560 neonatal intensive care units (NICUs) in 24 European countries to assess the usage of lung ultrasound (LU), revealing significant variability in adoption rates (20%-98%).
- Most NICUs (76%) use LU for clinical reasons, primarily to diagnose respiratory issues and manage acute conditions.
- Key barriers to LU implementation include lack of experience in technical skills and image interpretation, with suggestions for improvement involving specific training courses and a standardized international guideline.
Filar cyst on lumbar sonography prior to neonatal spinal anaesthesia.
Rev Esp Anestesiol Reanim (Engl Ed)
December 2024
Article Synopsis
- * The review highlights both normal lung characteristics and common respiratory issues in neonates, such as TTN and RDS, emphasizing the importance of ultrasound for diagnosis and treatment planning.
- * Lung ultrasound can also streamline care in non-NICU settings by assessing respiratory distress severity and guiding early interventions like surfactant therapy, making it valuable for all pediatricians.
Background: We aimed to determine the prevalence and severity of glomerular and tubular renal dysfunction by means of urinalysis in infants and toddlers with congenital cytomegalovirus infection (cCMV) and their association with cCMV disease, viruria and antiviral treatment.
Methods: This cross-sectional study was done using the Spanish Registry of Congenital Cytomegalovirus Infection. First-morning urine samples were collected from January 2016 to December 2018 from patients <5 years old enrolled in Spanish Registry of Congenital Cytomegalovirus Infection.
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 (FiO) exceeds 0.30.
View Article and Find Full Text PDFIntroduction: Early targeted surfactant therapy for preterm infants is recommended but the best criteria to personalize treatment are unclear. We validate a previously published multivariate prognostic model based on gestational age (GA), lung ultrasound score (LUS), and oxygen saturation to inspire oxygen fraction ratio (SatO2/FiO2) using an independent data set.
Methods: Pragmatic, observational study in 10 Italian and Spanish NICUs, including preterm babies (250 and 336 weeks divided into 3 GA intervals) with clinical signs of respiratory distress syndrome and stabilized on CPAP.
Bronchopulmonary dysplasia (BPD) is a multifactorial disease with many associated co-morbidities, responsible for most cases of chronic lung disease in childhood. The use of imaging exams is pivotal for the clinical care of BPD and the identification of candidates for experimental therapies and a closer follow-up. Imaging is also useful to improve communication with the family and objectively evaluate the clinical evolution of the patient's disease.
View Article and Find Full Text PDFDiaphragm ultrasound (DU) has been used in adult and pediatric critical patients in relation to prediction of extubation success or to detect diaphragm dysfunction, but there is a lack of evidence in neonates. Our aim is to study the evolution of diaphragm thickness in preterm infants, as well as related variables. This prospective monocentric observational study included preterm infants born before 32 weeks (PT32).
View Article and Find Full Text PDFIntroduction: Congenital pulmonary malformations are a heterogeneous group of embryological alterations at different stages of lung development, the most frequent being the congenital malformation of the airway. Lung ultrasound is a very useful tool in neonatal intensive care units, providing great value for differential diagnosis, as well as therapeutic response or early detection of complications.
Case Report: The case is a newborn of 38weeks' gestation who was followed by prenatal ultrasound control for suspected adenomatous cystic malformation type III in the left lung from week 22.
Article Synopsis
- The lung ultrasound score (LUS) can help predict moderate-severe bronchopulmonary dysplasia (msBPD) in preterm infants, and this study aimed to understand how LUS changes over time based on gestational age.
- A multicenter study analyzed 339 preterm infants, categorizing them into two gestational age groups (23-27 weeks and 28-32 weeks) and tracking their LUS evolution up to 36 weeks postmenstrual age.
- Results showed that infants in the earlier group had a steady increase in LUS initially, followed by a decrease, while the later group experienced a continuous decrease, with significant differences noted based on the need for surfactant and diagnosis of msBPD.
Unlabelled: The N-terminal end of B-type natriuretic peptide (NT-proBNP) and lung ultrasound (LUS) score have been proven to be adequate early biomarkers of bronchopulmonary dysplasia (BPD) in preterm infants. Our aim was to study if the predictive capacity of each one is increased by analyzing them together. We included infants born before 32 weeks with NT-proBNP and LUS scores on the first day of life (DOL) and on the 3rd, 7th, and 14th DOL and compared the diagnostic ability for moderate-severe BPD (msBPD) of each biomarker and in combination.
View Article and Find Full Text PDFArticle Synopsis
- A nationwide survey was conducted to understand the perceptions and implementation of ultrasound-guided vascular access (USG-VA) among neonatologists in Spain, revealing that 81% see it as essential in clinical practice.
- Although many recognize its importance, 35.5% have never applied it on real patients, and most perform fewer than 5 procedures annually.
- The lack of proper training is considered the main barrier to its use, with 87% of neonatologists advocating for formal training in USG-VA for future doctors.
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.
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