1. Lung Ultrasound Score Progress in Neonatal Respiratory Distress Syndrome
- Author
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Fabio Mosca, Silvia Lama, Sara Gatto, Letizia Capasso, Fabio Meneghin, Alessandro Perri, Stefano Nobile, Virgilio P. Carnielli, Iuri Corsini, Giovanni Vento, Marilena Savoia, Salvatore Aversa, Valentina Leonardi, Pasquale Dolce, Silvia Varano, Gianluca Lista, Fiorella Migliaro, Francesco Raimondi, Luca Pierri, Carlo Dani, Raimondi, F., Migliaro, F., Corsini, I., Meneghin, F., Dolce, P., Pierri, L., Perri, A., Aversa, S., Nobile, S., Lama, S., Varano, S., Savoia, M., Gatto, S., Leonardi, V., Capasso, L., Carnielli, V. P., Mosca, F., Dani, C., Vento, G., and Lista, G.
- Subjects
Male ,Neonatal respiratory distress syndrome ,medicine.medical_specialty ,Point-of-Care Systems ,Population ,Gestational Age ,Sensitivity and Specificity ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,030225 pediatrics ,Ductus arteriosus ,Intensive Care Units, Neonatal ,medicine ,Humans ,Prospective Studies ,education ,Prospective cohort study ,Lung ,Oxygen saturation (medicine) ,Bronchopulmonary Dysplasia ,Ultrasonography ,education.field_of_study ,Respiratory Distress Syndrome, Newborn ,business.industry ,Obstetrics ,Infant, Newborn ,Gestational age ,Infant ,medicine.disease ,Oxygen ,medicine.anatomical_structure ,N/A ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Bronchopulmonary dysplasia ,Pneumothorax ,Pediatrics, Perinatology and Child Health ,Female ,business ,Infant, Premature - Abstract
BACKGROUND AND OBJECTIVES: The utility of a lung ultrasound score (LUS) has been described in the early phases of neonatal respiratory distress syndrome (RDS). We investigated lung ultrasound as a tool to monitor respiratory status in preterm neonates throughout the course of RDS. METHODS: Preterm neonates, stratified in 3 gestational age cohorts (25–27, 28–30, and 31–33 weeks), underwent lung ultrasound at weekly intervals from birth. Clinical data, respiratory support variables, and major complications (sepsis, patent ductus arteriosus, pneumothorax, and persistent pulmonary hypertension of the neonate) were also recorded. RESULTS: We enrolled 240 infants in total. The 3 gestational age intervals had significantly different LUS patterns. There was a significant correlation between LUS and the ratio of oxygen saturation to inspired oxygen throughout the admission, increasing with gestational age (b = −0.002 [P < .001] at 25–27 weeks; b = −0.006 [P < .001] at 28–30 weeks; b = −0.012 [P < .001] at 31–33 weeks). Infants with complications had a higher LUS already at birth (12 interquartile range 13–8 vs 8 interquartile range 12–4 control group; P = .001). In infants 25 to 30 weeks’ gestation, the LUS at 7 days of life predicted bronchopulmonary dysplasia with an area under the curve of 0.82 (95% confidence interval 0.71 to 93). CONCLUSIONS: In preterm neonates affected by RDS, the LUS trajectory is gestational age dependent, significantly correlates with the oxygenation status, and predicts bronchopulmonary dysplasia. In this population, LUS is a useful, bedside, noninvasive tool to monitor the respiratory status.
- Published
- 2021