Point-of-Care Ultrasound versus Chest X-Ray for Determining Lung Expansion Based on Rib Count in High-Frequency Oscillatory Ventilation

Abstract

<b><i>Introduction:</i></b> Chest X-ray (CXR) is the most prevalent method for evaluating lung expansion in high-frequency oscillatory ventilation (HFOV). The purpose of this study was to compare the accuracy of chest radiography with point-of-care ultrasound (POCUS) in determining lung expansion. <b><i>Methods:</i></b> This prospective study included newborns who required HFOV and were monitored in a neonatal intensive care unit. A single neonatologist assessed lung expansion with CXR and POCUS to measure the costal level of the right hemidiaphragm and compared the results. <b><i>Results:</i></b> A neonatologist performed 55 measurements in 28 newborns with a gestational age of 32 (23.2–39.4) weeks, followed by HFOV. The rib counts obtained from anterior chest ultrasonography and posterior CXR showed a statistically high concordance (<i>r</i> = 0.913, <i>p</i> &lt; 0.001). <b><i>Conclusion:</i></b> Lung ultrasonography is a reliable method for the evaluation of lung expansion based on rib count in patients with HFOV.