A Lung Ultrasound Severity Score Predicts Chronic Lung Disease in Preterm InfantsFunding None.
14 May 2018
16 November 2018
04 January 2019 (online)
Objective To test the hypothesis that a lung ultrasound severity score (LUSsc) can predict the development of chronic lung disease (CLD) in preterm neonates.
Study Design Preterm infants <30 weeks' gestational age were enrolled in this study. Lung ultrasound (LUS) was performed between 1 and 9 postnatal weeks. All ultrasound studies were done assessing three lung zones on each lung. Each zone was given a score between 0 and 3. A receiver operating characteristic curve was constructed to assess the ability of LUSsc to predict CLD.
Results We studied 27 infants at a median (interquartile range [IQR]) gestational age and birth weight of 26 weeks (25–29) and 780 g (530–1,045), respectively. Median (IQR) postnatal age at the time of LUS studies was 5 (2–8) weeks. Fourteen infants who developed CLD underwent 34 studies. Thirteen infants without CLD underwent 30 studies. Those who developed CLD had a higher LUSsc than those who did not (median [IQR] of scores: 9 [6–12] vs. 3 [1–4], p < 0.0001). An LUSsc cutoff of 6 has a sensitivity and specificity of 76 and 97% and positive and negative predictive values of 95 and 82%, respectively. Adding gestational age < 27 weeks improved sensitivity and specificity to 86 and 98% and positive and negative predictive values to 97 and 88%.
Conclusion LUSsc between 2 and 8 weeks can predict development of CLD in preterm neonates.
- 1 Evans N, Gournay V, Cabanas F. , et al. Point-of-care ultrasound in the neonatal intensive care unit: international perspectives. Semin Fetal Neonatal Med 2011; 16 (01) 61-68
- 2 Xirouchaki N, Magkanas E, Vaporidi K. , et al. Lung ultrasound in critically ill patients: comparison with bedside chest radiography. Intensive Care Med 2011; 37 (09) 1488-1493
- 3 Liu J, Cao H-Y, Wang X-L, Xiao L-J. The significance and the necessity of routinely performing lung ultrasound in the neonatal intensive care units. J Matern Fetal Neonatal Med 2016; 29 (24) 4025-4030
- 4 Copetti R, Cattarossi L. Lung ultrasound in newborns, infants, and children. In: Mathis G. , ed. Chest Sonography. Berlin, Heidelberg: Springer; 2011: 241-245
- 5 Elsayed Y, Abdelmawla M, Narvey M, Wrogemann J. A model of integrated lung and focused heart ultrasound as a new screening examination in infants at risk of respiratory or hemodynamic compromise. J Pediatr Neonatal Individ Med 2017; 6 (01) 1-14
- 6 Raimondi F, Rodriguez Fanjul J, Aversa S. , et al; Lung Ultrasound in the Crashing Infant (LUCI) Protocol Study Group. Lung ultrasound for diagnosing pneumothorax in the critically ill neonate. J Pediatr 2016; 175: 74-78
- 7 Brat R, Yousef N, Klifa R, Reynaud S, Shankar Aguilera S, De Luca D. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr 2015; 169 (08) e151797
- 8 Santos TM, Franci D, Coutinho CMG. , et al. A simplified ultrasound-based edema score to assess lung injury and clinical severity in septic patients. Am J Emerg Med 2013; 31 (12) 1656-1660
- 9 Kurepa D, Zaghloul N, Watkins L, Liu J. Neonatal lung ultrasound exam guidelines. J Perinatol 2018; 38 (01) 11-22
- 10 Wilson AC. What does imaging the chest tell us about bronchopulmonary dysplasia?. Paediatr Respir Rev 2010; 11 (03) 158-161