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Lung ultrasonography score versus chest X‐ray score to predict surfactant administration in newborns with respiratory distress syndrome
Author(s) -
Perri Alessandro,
Riccardi Riccardo,
Iannotta Rossella,
Di Molfetta Domenico V.,
Arena Roberta,
Vento Giovanni,
Zecca Enrico
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24076
Subject(s) - medicine , respiratory distress , gestational age , lung , prospective cohort study , respiratory system , surfactant therapy , neonatal respiratory distress syndrome , anesthesia , pregnancy , biology , genetics
Objectives We aim to verify the diagnostic accuracy of a lung ultrasonography (LUS) score to early predict the need for surfactant therapy in newborns with respiratory distress syndrome (RDS), and to compare it with a chest X‐ray score. Methods In this prospective diagnostic accuracy study we included all newborns admitted for respiratory distress and initially treated with nasal CPAP. LUS was performed within 2 h from nasal CPAP positioning and in any case before surfactant administration. A chest X‐ray was also performed. A LUS score and an X‐ray score were used and compared. Ability of the scores to predict surfactant administration was evaluated through ROC analysis. Results In our population of 56 newborns with mean gestational age of 31 weeks (SD 3) and mean birth weight of 1442 g (SD 520), LUS score showed higher AUC than X‐ray score in early recognition of infants with respiratory distress syndrome requiring surfactant treatment (0.94; 95%CI, 0.89‐0.98; P < 0.001 vs 0.80; 95%CI, 0.74‐0.86; P < 0.001). It showed also higher sensitivity (86% vs 82%), higher specificity (88% vs 76%), better positive (83% vs 69%), and negative (91% vs 87%) predictive values. Conclusions LUS is a non‐invasive, bedside and reproducible method that could improve the management of neonatal respiratory distress. It is accurate and reliable to early identify patients who will need treatment with surfactant allowing both an early treatment and a reduction of radiation exposure.