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

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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.

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Abbreviations

AUC:

Area under curve

BPD:

Bronchopulmonary dysplasia

BW:

Birth weight

GA:

Gestational age

LUS:

lung ultrasound

MV:

Mechanical ventilation

nCPAP:

nasal continuous positive airway pressure

NICU:

Neonatal intensive care unit

PTNB:

Preterm newborn

RD:

Respiratory distress

RDS:

Respiratory distress syndrome

ROC:

Receiver operating characteristics

TTN:

Neonatal transient tachypnoea

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Acknowledgements

This study had no financial support. We would like to thank Dr. Constancio Medrano López and Philips ® due to their technical support during the study period.

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Authors and Affiliations

  1. Neonatology Department, Virgen de la Salud Hospital, Toledo, Spain

    Rebeca Gregorio-Hernández

  2. Neonatology Department, Gregorio Marañón University Hospital, Madrid, Spain

    María Arriaga-Redondo, Alba Pérez-Pérez, Cristina Ramos-Navarro & Manuel Sánchez-Luna

Authors
  1. Rebeca Gregorio-Hernández
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  2. María Arriaga-Redondo
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  3. Alba Pérez-Pérez
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  4. Cristina Ramos-Navarro
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  5. Manuel Sánchez-Luna
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Contributions

Rebeca Gregorio-Hernández designed the study, performed the acquisition and analysis of the data and draft the text. María Arriaga-Redondo, Alba Pérez-Pérez and Cristina Ramos-Navarro collected data during the study period including performing lung ultrasound. María Arriaga-Redondo and Manuel Sánchez-Luna made contributions to the conception of the work and revised the work critically. All the authors revised and approved the final version of the text.

Corresponding author

Correspondence to Rebeca Gregorio-Hernández.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee (Gregorio Marañón Hospital, reference number 251/17) and the 1964 Declaration of Helsinki and its subsequent amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the legal guardians of all individual participants included in the study.

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Communicated by Patrick Van Reempts

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Gregorio-Hernández, R., Arriaga-Redondo, M., Pérez-Pérez, A. et al. Lung ultrasound in preterm infants with respiratory distress: experience in a neonatal intensive care unit. Eur J Pediatr 179, 81–89 (2020). https://doi.org/10.1007/s00431-019-03470-0

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  • DOI: https://doi.org/10.1007/s00431-019-03470-0

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