PMC9922992_01
Sonographic patterns of bronchodysplasia (BPD). Representative pictures of Lung Ultrasound (LUS) and echocardiography of the patients at the time of the beginning of therapy. (A-C) Case 1: (A) LUS showing homogenously and gravity-related distributed B-lines with a normal pleural line; (B) color-Doppler of the pulmonary artery showing normal flow; (C) B-mode evaluation of ventricular chambers showing normal eccentricity index (EI). (D-F) Case 2: (D) LUS showing inhomogeneous B-line distribution with spared areas of normal sonographic lung appearance, surrounded by areas containing multiple B-lines. Pleural line thickened and irregular; (E) color-Doppler of the pulmonary artery showing normal flow; (F) B-mode evaluation of ventricular chambers showing normal EI. (G-I) Case 3: (G) LUS homogenously and gravity-related distributed B-lines with subpleural atelectasis of the dependent regions; (H) color-Doppler of the patent ductus arteriosus showing pulsatile flow; (I) M-mode evaluation of the left atrium (LA) to aorta (Ao) ratio, showing important dilation of the ratio atrium (LA:Ao = 2); (L-N) Case 4: (L) LUS showing confluent B-lines with sparing areas, thickened pleural line, and with subpleural atelectasis; (M) color-Doppler of the pulmonary artery showing decreased acceleration time/ejection time (AT/ET) = 0.28; (N) B-mode evaluation of ventricular chambers showing decreased EI (EI = 1.2).
fped-10-1112313-g001.jpg
PMC9922992_05_fped-10-1112313-g001.jpg
F1
Furthermore, significant signs of acute and chronic placental underperfusion were reported (Figure 1).
Histological examination of the placentas. Representative pictures of the histological examination of the placenta. H & E 5x: Hematoxylin and eosin stain at 5 magnifications; H & E 10x: Hematoxylin and eosin stain at 10 magnification; IHC-CD34: Immunohistochemistry stains for cluster of differentiation. (A-C) Case 1: (A) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (B) H & E showing absence of vasculitis; (C) IHC showing normal distribution of CD34 in the placental vessels. (D-F) Case 2: (D) H & E stain showing severe chorioamnionitis; (E) H & E stain showing severe vasculitis; (F) IHC showing normal distribution of CD34 in the placental vessels. (G-I) Case 3: (G) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (H) H & E showing absence of vasculitis; (I) IHC showing normal distribution of CD34 in the placental vessels; (L-N) Case 4: (L) H & E showing severe chorioamnionitis and acute ischemic area of malperfusion; (M) H & E stain showing severe vasculitis and funisitis; (N) IHC showing severe suppression of CD34 expression.
fped-10-1112313-g002.jpg
PMC9922992_05_fped-10-1112313-g002.jpg
F2
TnEcho showed signs of pulmonary hypertension (PH) (Figure 2).
PMC9922992_02
Sonographic patterns of bronchodysplasia (BPD). Representative pictures of Lung Ultrasound (LUS) and echocardiography of the patients at the time of the beginning of therapy. (A-C) Case 1: (A) LUS showing homogenously and gravity-related distributed B-lines with a normal pleural line; (B) color-Doppler of the pulmonary artery showing normal flow; (C) B-mode evaluation of ventricular chambers showing normal eccentricity index (EI). (D-F) Case 2: (D) LUS showing inhomogeneous B-line distribution with spared areas of normal sonographic lung appearance, surrounded by areas containing multiple B-lines. Pleural line thickened and irregular; (E) color-Doppler of the pulmonary artery showing normal flow; (F) B-mode evaluation of ventricular chambers showing normal EI. (G-I) Case 3: (G) LUS homogenously and gravity-related distributed B-lines with subpleural atelectasis of the dependent regions; (H) color-Doppler of the patent ductus arteriosus showing pulsatile flow; (I) M-mode evaluation of the left atrium (LA) to aorta (Ao) ratio, showing important dilation of the ratio atrium (LA:Ao = 2); (L-N) Case 4: (L) LUS showing confluent B-lines with sparing areas, thickened pleural line, and with subpleural atelectasis; (M) color-Doppler of the pulmonary artery showing decreased acceleration time/ejection time (AT/ET) = 0.28; (N) B-mode evaluation of ventricular chambers showing decreased EI (EI = 1.2).
fped-10-1112313-g001.jpg
PMC9922992_05_fped-10-1112313-g001.jpg
F1
Furthermore, significant signs of acute and chronic placental underperfusion were reported (Figure 1).
Histological examination of the placentas. Representative pictures of the histological examination of the placenta. H & E 5x: Hematoxylin and eosin stain at 5 magnifications; H & E 10x: Hematoxylin and eosin stain at 10 magnification; IHC-CD34: Immunohistochemistry stains for cluster of differentiation. (A-C) Case 1: (A) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (B) H & E showing absence of vasculitis; (C) IHC showing normal distribution of CD34 in the placental vessels. (D-F) Case 2: (D) H & E stain showing severe chorioamnionitis; (E) H & E stain showing severe vasculitis; (F) IHC showing normal distribution of CD34 in the placental vessels. (G-I) Case 3: (G) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (H) H & E showing absence of vasculitis; (I) IHC showing normal distribution of CD34 in the placental vessels; (L-N) Case 4: (L) H & E showing severe chorioamnionitis and acute ischemic area of malperfusion; (M) H & E stain showing severe vasculitis and funisitis; (N) IHC showing severe suppression of CD34 expression.
fped-10-1112313-g002.jpg
PMC9922992_05_fped-10-1112313-g002.jpg
F2
TnEcho showed signs of pulmonary hypertension (PH) (Figure 2).
Patient clinical course. Graphics representing the need for respiratory assistance of each patient. The vertical axis shows the mean fraction of inspired oxygen (FiO2) needs for each day, the horizontal axis represents the post-menstrual age (PMA). The time-point for each specific (cardiopulmonary ultrasound (CPUS) guided intervention is highlighted in each graphic.
fped-10-1112313-g003.jpg
PMC9922992_05_fped-10-1112313-g003.jpg
F3
Oxygen and non-invasive ventilation were promptly weaned, and the patient was breathing without support on room air on the day of life 8 (31 + 4 weeks of PMA) (Figure 3). The respiratory status rapidly improved and six days later (37 + 6 weeks of PMA), the patient no longer needed supplemental oxygen (Figure 3).
PMC9922992_03
PMC9922992_04
Sonographic patterns of bronchodysplasia (BPD). Representative pictures of Lung Ultrasound (LUS) and echocardiography of the patients at the time of the beginning of therapy. (A-C) Case 1: (A) LUS showing homogenously and gravity-related distributed B-lines with a normal pleural line; (B) color-Doppler of the pulmonary artery showing normal flow; (C) B-mode evaluation of ventricular chambers showing normal eccentricity index (EI). (D-F) Case 2: (D) LUS showing inhomogeneous B-line distribution with spared areas of normal sonographic lung appearance, surrounded by areas containing multiple B-lines. Pleural line thickened and irregular; (E) color-Doppler of the pulmonary artery showing normal flow; (F) B-mode evaluation of ventricular chambers showing normal EI. (G-I) Case 3: (G) LUS homogenously and gravity-related distributed B-lines with subpleural atelectasis of the dependent regions; (H) color-Doppler of the patent ductus arteriosus showing pulsatile flow; (I) M-mode evaluation of the left atrium (LA) to aorta (Ao) ratio, showing important dilation of the ratio atrium (LA:Ao = 2); (L-N) Case 4: (L) LUS showing confluent B-lines with sparing areas, thickened pleural line, and with subpleural atelectasis; (M) color-Doppler of the pulmonary artery showing decreased acceleration time/ejection time (AT/ET) = 0.28; (N) B-mode evaluation of ventricular chambers showing decreased EI (EI = 1.2).
fped-10-1112313-g001.jpg
PMC9922992_05_fped-10-1112313-g001.jpg
F1
Furthermore, significant signs of acute and chronic placental underperfusion were reported (Figure 1).
Histological examination of the placentas. Representative pictures of the histological examination of the placenta. H & E 5x: Hematoxylin and eosin stain at 5 magnifications; H & E 10x: Hematoxylin and eosin stain at 10 magnification; IHC-CD34: Immunohistochemistry stains for cluster of differentiation. (A-C) Case 1: (A) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (B) H & E showing absence of vasculitis; (C) IHC showing normal distribution of CD34 in the placental vessels. (D-F) Case 2: (D) H & E stain showing severe chorioamnionitis; (E) H & E stain showing severe vasculitis; (F) IHC showing normal distribution of CD34 in the placental vessels. (G-I) Case 3: (G) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (H) H & E showing absence of vasculitis; (I) IHC showing normal distribution of CD34 in the placental vessels; (L-N) Case 4: (L) H & E showing severe chorioamnionitis and acute ischemic area of malperfusion; (M) H & E stain showing severe vasculitis and funisitis; (N) IHC showing severe suppression of CD34 expression.
fped-10-1112313-g002.jpg
PMC9922992_05_fped-10-1112313-g002.jpg
F2
TnEcho showed signs of pulmonary hypertension (PH) (Figure 2).
PMC9922992_05
Sonographic patterns of bronchodysplasia (BPD). Representative pictures of Lung Ultrasound (LUS) and echocardiography of the patients at the time of the beginning of therapy. (A-C) Case 1: (A) LUS showing homogenously and gravity-related distributed B-lines with a normal pleural line; (B) color-Doppler of the pulmonary artery showing normal flow; (C) B-mode evaluation of ventricular chambers showing normal eccentricity index (EI). (D-F) Case 2: (D) LUS showing inhomogeneous B-line distribution with spared areas of normal sonographic lung appearance, surrounded by areas containing multiple B-lines. Pleural line thickened and irregular; (E) color-Doppler of the pulmonary artery showing normal flow; (F) B-mode evaluation of ventricular chambers showing normal EI. (G-I) Case 3: (G) LUS homogenously and gravity-related distributed B-lines with subpleural atelectasis of the dependent regions; (H) color-Doppler of the patent ductus arteriosus showing pulsatile flow; (I) M-mode evaluation of the left atrium (LA) to aorta (Ao) ratio, showing important dilation of the ratio atrium (LA:Ao = 2); (L-N) Case 4: (L) LUS showing confluent B-lines with sparing areas, thickened pleural line, and with subpleural atelectasis; (M) color-Doppler of the pulmonary artery showing decreased acceleration time/ejection time (AT/ET) = 0.28; (N) B-mode evaluation of ventricular chambers showing decreased EI (EI = 1.2).
fped-10-1112313-g001.jpg
PMC9922992_05_fped-10-1112313-g001.jpg
F1
Furthermore, significant signs of acute and chronic placental underperfusion were reported (Figure 1).
Histological examination of the placentas. Representative pictures of the histological examination of the placenta. H & E 5x: Hematoxylin and eosin stain at 5 magnifications; H & E 10x: Hematoxylin and eosin stain at 10 magnification; IHC-CD34: Immunohistochemistry stains for cluster of differentiation. (A-C) Case 1: (A) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (B) H & E showing absence of vasculitis; (C) IHC showing normal distribution of CD34 in the placental vessels. (D-F) Case 2: (D) H & E stain showing severe chorioamnionitis; (E) H & E stain showing severe vasculitis; (F) IHC showing normal distribution of CD34 in the placental vessels. (G-I) Case 3: (G) H & E showing normal placenta for the gestational age with mild signs of chorioamnionitis; (H) H & E showing absence of vasculitis; (I) IHC showing normal distribution of CD34 in the placental vessels; (L-N) Case 4: (L) H & E showing severe chorioamnionitis and acute ischemic area of malperfusion; (M) H & E stain showing severe vasculitis and funisitis; (N) IHC showing severe suppression of CD34 expression.
fped-10-1112313-g002.jpg
PMC9922992_05_fped-10-1112313-g002.jpg
F2
TnEcho showed signs of pulmonary hypertension (PH) (Figure 2).
Patient clinical course. Graphics representing the need for respiratory assistance of each patient. The vertical axis shows the mean fraction of inspired oxygen (FiO2) needs for each day, the horizontal axis represents the post-menstrual age (PMA). The time-point for each specific (cardiopulmonary ultrasound (CPUS) guided intervention is highlighted in each graphic.
fped-10-1112313-g003.jpg
PMC9922992_05_fped-10-1112313-g003.jpg
F3
Oxygen and non-invasive ventilation were promptly weaned, and the patient was breathing without support on room air on the day of life 8 (31 + 4 weeks of PMA) (Figure 3). The respiratory status rapidly improved and six days later (37 + 6 weeks of PMA), the patient no longer needed supplemental oxygen (Figure 3).