Lung ultrasound in preterm infants with respiratory distress: experience in a neonatal intensive care unit

Eur J Pediatr. 2020 Jan;179(1):81-89. doi: 10.1007/s00431-019-03470-0. Epub 2019 Oct 26.

Abstract

Lung ultrasound (LUS) has been described as a useful tool in early prognosis of several respiratory diseases of the newborn, especially preterm infant newborns (PTNB) with respiratory distress syndrome (RDS), but still, it is not a standard of care in many neonatal units. We have conducted a descriptive, prospective study in a tertiary neonatal unit during 1 year. PTNB less than 35 weeks with respiratory distress at birth on non-invasive ventilation were recruited. A LUS was performed in the first 12 h of life and scored from 6 to 18 points (6 areas, 1 to 3 points each). They were followed until discharge. Main outcomes: need for surfactant treatment. Sixty-four preterm infants, median gestational age 29 weeks. Median LUS score in surfactant group was significantly higher than in no surfactant group (p < 0.0001). LUS ROC curve for surfactant treatment shows AUC 0.97 (IC 95% 0.92-1). LUS Odds ratio for surfactant treatment 3.17 (IC 95% 1.36-7.35).Conclusion: Early high LUS score correlates with surfactant necessity in preterm infants with respiratory distress at birth.What is Known:• Lung ultrasound (LUS) is a useful tool in determining prognosis of preterm infants with respiratory distress at birth.What is New:• This study adds evidence about LUS and preterm infants with respiratory distress, early predicting surfactant need and mechanical ventilation.

Keywords: Lung ultrasound; Preterm infants; Respiratory distress; Sonography; Surfactant treatment.

Publication types

  • Observational Study

MeSH terms

  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Intensive Care, Neonatal / methods*
  • Lung / diagnostic imaging*
  • Male
  • Noninvasive Ventilation
  • Prognosis
  • Prospective Studies
  • Pulmonary Surfactants / therapeutic use
  • ROC Curve
  • Respiratory Distress Syndrome, Newborn / diagnostic imaging*
  • Respiratory Distress Syndrome, Newborn / therapy
  • Ultrasonography

Substances

  • Pulmonary Surfactants