The clinical value of lung ultrasound in premature infants with bronchopulmonary dysplasia

Abstract

OBJECTIVE: This study aimed to explore the risk factors of bronchopulmonary dysplasia in premature infants and the clinical application value of lung ultrasound in the diagnosis of bronchopulmonary dysplasia. METHODS: A total of 80 premature infants with a gestational age of <32 weeks or a birth weight of <1,500 g who were treated in our hospital from January to August 2021 were randomly divided into a bronchopulmonary dysplasia group (n=12) and a non-bronchopulmonary dysplasia group (n=62). The clinical data, lung ultrasound, and X-ray image characteristics of the two groups were compared. RESULTS: Among the 74 preterm infants, 12 preterm infants were diagnosed with bronchopulmonary dysplasia, and 62 preterm infants were determined not to have bronchopulmonary dysplasia. There were significant differences in sex, severe asphyxia, invasive mechanical ventilation, premature membrane ruptures, and intrauterine infection between the two groups (p<0.05). Lung ultrasound showed abnormal pleural lines and alveolar-interstitial syndrome in all 12 patients with bronchopulmonary dysplasia and vesicle inflatable signs in 3 patients. Before clinical diagnosis, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of lung ultrasound in the diagnosis of bronchopulmonary dysplasia were 98.65, 100, 98.39, 92.31, and 100%, respectively. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of X-rays in the diagnosis of bronchopulmonary dysplasia were 85.14, 75.00, 87.10, 52.94, and 94.74%, respectively. CONCLUSION: The diagnostic efficiency of lung ultrasound for premature bronchopulmonary dysplasia is better than that of X-rays. The application of lung ultrasound can screen patients with bronchopulmonary dysplasia early for timely intervention.

Diagnostic Accuracy of Lung Ultrasound in Neonatal Diseases: A Systematized Review

“…One of the presented studies was a meta-analysis [31], which showed the early LUS with a less extensive score has 70-80% sensitivity and 80-87% specificity in predicting BPD. Other studies, including prospective ones [32,33], confirmed this finding, even if a relatively low number of extremely preterm infants were enrolled; moreover, in these studies, LUS was more accurate than CXR for BPD prediction. Other studies confirmed the utility of LUS performed at 14 days of life in extremely preterm infants [35] and the role of lung consolidations detected in the first weeks of life for the prediction of BPD [36].…”

“…Xu et al [ 32 ] compared the predictive role of LUS and CXR in preterm infants. They conducted a study with 248 eligible infants, of which 80 were randomly enrolled and divided into a BPD group ( n = 12) and a non-BPD group ( n = 62); they showed that the diagnostic accuracy of lung ultrasound for bronchopulmonary dysplasia was better than that of X-rays (98.7% vs. 85.1%).…”