Daniel Ibarra-Ríos, Expresidente, Asociación de Neonatólogos de la Ciudad y Valle de México; Servicio de Investigación Clínica, Hospital Infantil de México Federico Gómez. Ciudad de México, México
Eunice V. Serpa-Maldonado, Departamento de Neonatología, Hospital General de Atizapán de Zaragoza Dr. Salvador González Herrejón, Edo. de México, México
Karla C. Trejo-Sánchez, Departamento de Neonatología, Star Médica Hospital Infantil Privado, Ciudad de México, México
Alejandra Sánchez-Cruz, Departamento de Neonatología, Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 4, Luis Castelazo Ayala, Ciudad de México, México
Deneb A. Morales-Barquet, Departamento de Neonatología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México, México
Martha J. Avilés-Robles, Departamento de Infectología, Hospital Infantil de México Federico Gómez, Ciudad de México, México
Horacio Márquez-González, Servicio de Investigación Clínica, Hospital Infantil de México Federico Gómez, Ciudad de México, México
Background: Respiratory viruses are a frequent cause of infection in neonatology. Point-of-care lung ultrasound (LU) and targeted neonatal echocardiography (TnE) allow pulmonary and hemodynamic assessment at the patient’s bedside. Methods: The aim of this study was to describe the pattern of alterations found by LU and to assess the hemodynamic status in neonates diagnosed with viral infection (reverse transcription polymerase chain reaction) during 2018-2023. LU was performed in 10 regions, and a semi-quantitative scale LU score (LUS) was calculated. TnE was performed if pulmonary hypertension (PH) was suspected. The thymus was measured by ultrasound if there was evidence of increased dimensions on chest X-ray or during LU. Results: Forty-seven patients were studied (35 severe acute respiratory syndrome coronavirus 2, four respiratory syncytial virus, four rhinovirus, three influenza, and one parainfluenza). LU showed an interstitial pattern of B-lines in 94%, pleural line anomalies in 85%, coalescing B-lines in 60%, and consolidations in 51% (71% posteriorly). About 30% had PH. An increased thymus was shown in 23%. LUS showed a significant median difference between ventilatory support and a positive correlation with FiO2 used. Consolidations and the presence of PH were associated with mortality; an increased thymus was shown protective. Conclusion: Ultrasound at the patient’s bedside allows the classification and detection of the seriously ill patient (presence of consolidations and PH) allowing timely intervention. As a clinical finding, an increased thymus was shown to be a protective factor against mortality and could represent a marker of adequate immune response.
Keywords: POCUS. Severe acute respiratory syndrome coronavirus 2. Lung ultrasound. Respiratory viruses. Thymus. Pulmonary hypertension.
