Aim: Neonatal respiratory distress syndrome (NRDS) is one of the most common and severe diseases in neonatal intensive care units worldwide. Increasing evidence suggests that lung ultrasound (LUS) may be a reliable diagnostic tool for neonatal respiratory distress syndrome. The aim of study was to evaluate the diagnostic accuracy of LUS for NRDS with a systematic review and meta-analysis.Material and methods: We searched for articles in EMBASE, PubMed and Cochrane Central from inception until 17 August 2019. The selected studies were diagnostic accuracy studies that reported the utility of LUS in the diagnosis of NRDS. Two researchers independently extracted data and assessed quality using the QUADAS-2 tool. Then, we created a bivariate mixed effects model to calculate the sensitivity and specificity of LUS in diagnosing NRDS. A summary receiver operator characteristic (SROC) curve was constructed to summarize the performance characteristics of LUS.Results: Nine studies involving 703 infants were included in the review. LUS had a pooled sensitivity of 0.99 (CI: 0.92-1.00) and a specificity of 0.95 (CI: 0.87-0.98). The areas under the curve for LUS was 0.99 (0.98-1.0). Meta-regression revealed that LUS had a significant diagnostic accuracy for NRDS.Conclusion: LUS is a promising method that is easily carried out, inexpensive, nonionizing and repeatable and can be performed at the bedside. Current evidence supports LUS as a useful imaging alternative for the diagnosis of NRDS.

Background Lung ultrasound (LUS) is widely used in the management of neonatal pneumonia, our previous research has confirmed that LUS cannot identify the etiologies of neonatal pneumonia. However, there is still controversy and confusion regarding whether LUS can differentiate between different types of pneumonia (such as intrauterine infectious pneumonia (IP), ventilator-associated pneumonia (VAP), community-acquired pneumonia (CAP), meconiumaspiration pneumonia (MAP)). Therefore, we have organized this prospective multicenter study to address and answer these remaining questions. Methods A prospective approach was used to collect LUS data on neonatal all kinds of pneumonia from 5 tertiary hospitals in China. The patients were devided into three categories: based on whether there is evidence of infection,ventilator treatment ot the history of meconium aspiration, they are classified as IP and non-IP, VAP and non-VAP, MAP and non-MAP. The major LUS imaging characteristics and complications were compared among groups. Results A total of 235 patients with neonatal pneumonia were included, comprising 195 patients with IP and 40 patients with non-IP. The ultrasound characteristics included pleural line abnormalities in all 235 patients, involving zones 1–12;B-lines in 174 patients, involving zones 1–12;lung consolidation in all 235 patients, involving zones 1–12%; pneumothorax in 4 patients; and pleural effusion in 31 patients.No significant differences in ultrasound characteristics were found between patients with MAP and patients with non-MAP or between patients with-or without VAP.Compared with IP,aspiration pneumonia was associated with a significantly greater incidence of right lung consolidation (100% vs. 89.2%),with no significant differences in other ultrasound signs. Conclusion The results of this study show that the most common ultrasound imaging manifestations of various etiologies of pneumonia in newborns are lung consolidation accompanied by airbronchograms.Differentiating between various types of pneumonia still requires the combination of medical history and relevant laboratory tests.

Background: Investigate the feasibility of umbilical vein catheter insertion without umbilical remnants. Methods:A total of 72 infants who needed umbilical vein catheter insertion was included. The study was conducted from October 1, 2020, to December 10, 2022, from the neonatal intensive care unit at HuiZhou Central People’s Hospital. The infants were categorized into the two groups according to whether their umbilical stumps were ligated to the end near the annulus umbilicalis using a rubber-ring or suture line. Umbilical vein catheter tip positions, medications given via umbilical vein catheter, duration from birth to insertion, duration of umbilical vein catheter indwelling time, removal for no blood aspiration, limited use, unplanned removal, and any umbilical catheter-associated complications were compared between two groups. Results:In comparisons of umbilical vein catheter tip positions, characteristics of utilization and complications revealed no statistically significant differences. The duration from birth to insertion in the group without remnants was 7.82 hours (range 4.44-14.57), while it was 11.89 hours (range 5.50-20.34) in the group with remnants. The duration of umbilical vein catheter indwelling time in the group without remnants was 6.50±3.06 days, while it was 6.10±2.76 days in the group with remnants.In the group without remnants, 12.5% (4/32) experienced abdominal distension compared with 5.0% (2/40) in the group with remnants. Gastrointestinal hemorrhage was 12.5% (4/32) versus 2.5% (1/40). Conlusions: This study indicates that it is practical to perform umbilical vein catheter insertion without umbilical remnants. It provides another way to obtain vessel access for initial stabilization. Registration number is ChiCTR2300071411. Date of registration：15/05/2023, retrospectively registered

Lung ultrasound (LUS) is being increasingly used to diagnose neonatal pneumonia. However, whether LUS can distinguish between infectious pneumonia (IP) and