Reproducibility and reference values of diaphragmatic shortening fraction for term and premature infants
Background New ultrasound measurements to diagnose diaphragmatic dysfunction, including diaphragmatic shortening fraction (DSF), have been studied in adults and children, but there are no data on reference values for neonates. Objective To describe DSF reference values for term neonate (TN) and pret...
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| Published in: | Pediatric pulmonology Vol. 55; no. 8; pp. 1963 - 1968 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Wiley Subscription Services, Inc
01-08-2020
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background
New ultrasound measurements to diagnose diaphragmatic dysfunction, including diaphragmatic shortening fraction (DSF), have been studied in adults and children, but there are no data on reference values for neonates.
Objective
To describe DSF reference values for term neonate (TN) and preterm neonate (PTN), and to calculate its reproducibility.
Methods
We included asymptomatic TN and PTN during their first 24 hours of life. We measured DSF at the zone of apposition in both hemithoraces. Reproducibility of image acquisition, including inter‐ and intra‐rater agreement of the measurements were calculated among an experienced and a novel operator (after completion of a 1‐day course on lung ultrasound [LU] and performance of 10 diaphragm ultrasounds [DUs] under supervision), and a more‐trained examiner (completion of a 1‐day course on LU and performance of 60 DUs under supervision).
Results
Two groups of 33 TN and 33 PTN were studied. Median DSF values did not differ between the groups, although diaphragm thickness was higher in the TN group. Intra‐observer reproducibility: the intraclass correlation coefficient (ICC) was 0.95 (95% confidence interval [95% CI] 0.86‐0.98). Interobserver reproducibility with novel operator had an ICC of 0.42 (95% CI −0.74 to 0.81), and with a more experienced operator improved to 0.76 (95% CI 0.27‐0.92). Both intra‐ and interobserver agreement were high.
Conclusions
Asymptomatic TN and PTN have similar DSF values in the first 24 hours of life. The intra‐ and interobserver agreement is high. Reproducibility is acceptable, but intensive training is necessary to perform adequate DU. |
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| Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
| ISSN: | 8755-6863 1099-0496 |
| DOI: | 10.1002/ppul.24866 |