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Neonatal lung ultrasonography score after surfactant in preterm infants: A prospective observational study
Author(s) -
Perri Alessandro,
Tana Milena,
Riccardi Riccardo,
Iannotta Rossella,
Giordano Lucia,
Rubortone Serena Antonia,
Priolo Francesca,
Di Molfetta Domenico V.,
Zecca Enrico,
Vento Giovanni
Publication year - 2020
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.24566
Subject(s) - medicine , gestational age , respiratory distress , neonatal intensive care unit , surfactant therapy , pulmonary surfactant , confidence interval , prospective cohort study , birth weight , observational study , gestation , low birth weight , pediatrics , anesthesia , pregnancy , genetics , physics , biology , thermodynamics
Objective To assess changes in neonatal lung ultrasonography score (nLUS) after surfactant administration in preterm infants with respiratory distress syndrome (RDS). Working Hypothesis The reduction of nLUS score before (nLUSpre), 2 hours (nLUS2h), and 12 hours (nLUS12h) after surfactant administration to identify patients who will not need a second treatment. Study Design and Setting Prospective observational study in the tertiary neonatal intensive care unit. Patients Selection Forty‐six preterm neonates with RDS of 32 weeks median gestational age (IQR 30‐33) and mean birth weight of 1650 ± 715 g. Methodology Lung ultrasonography was performed before, 2 hours, and 12 hours after surfactant administration in preterm infants with RDS needing surfactant treatment. Resulting nLUS was analyzed. Results The Wilcoxon signed‐rank test demonstrated an nLUS lowering after 2 hours ( P < .001) and 12 hours ( P < .001) from surfactant administration. Sixteen newborns required surfactant retreatment with median gestational age of 32 weeks (IQR 29‐33) and mean birth weight of 1519 ± 506 g.The receiver operating characteristic analysis for the nLUS2h yielded an area under the curve of 0.80 (95% confidence interval, 0.76‐0.85; P < .001). A nLUS2h ≥7 showed a sensitivity of 94% and a specificity of 60% for needing a second treatment with surfactant. Conclusions In preterm infants with RDS requiring surfactant treatment, nLUS evaluated 2 hours after surfactant administration can be used to identify patients who will not need a second treatment.