Accuracy of lung ultrasound in predicting extubation failure in neonates: A systematic review and meta‐analysis

Mohsen, Nada; Solís-García, Gonzalo; Jasani, Bonny; Nasef, Nehad; Mohamed, Adel

doi:10.1002/ppul.26598

Cited by 7 publications

(2 citation statements)

References 45 publications

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“…Other authors reported that the LUS score but not diaphragmatic excursion parameters could predict extubation failure [ 50 ]. According to a recent meta-analysis, LUS had good sensitivity and specificity in predicting extubation failure; however, the level of evidence and the methodological heterogeneity observed preclude firm conclusions [ 51 ].…”

Section: Resultsmentioning

confidence: 99%

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

Nobile,

Sette,

Esposito

et al. 2024

JCM

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Background: Respiratory problems are frequent in newborns, and are mainly studied with chest X-rays, whereas CT scans are usually needed for the evaluation of rare malformations and diseases. Lung ultrasound (LUS] has been proposed as an alternative method of diagnosing a variety of respiratory conditions. In recent years, there has been a rapid increase in LUS studies, thanks to the ability of LUS to rapidly exclude complications and significantly reduce radiation exposure in this fragile population. We aimed to summarize the current knowledge about LUS. Methods: A literature search was conducted on the Medline and Cochrane databases using appropriate terms. The inclusion criteria were: English language and human species. Exclusion criteria were: non-English language, animal species, case reports, case series, non-systematic reviews, and editorials. Results: The search returned 360 results. No Cochrane reviews were found. Titles and abstracts were screened, and 37 were finally considered. Studies concerning the use of lung ultrasound for the following conditions were presented: neonatal respiratory distress syndrome, transient tachypnea of the newborn, pneumothorax, pulmonary hemorrhage, pneumonia, bronchopulmonary dysplasia, and prediction of extubation success. Conclusions: We discussed the utility of LUS for the diagnosis and treatment of neonatal diseases according to the most recent literature.

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Section: Resultsmentioning

confidence: 99%

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

Nobile,

Sette,

Esposito

et al. 2024

JCM

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“…The results of these studies showed that LU can be used to diagnose respiratory distress syndrome,5 transient tachypnoea of the newborn,1 pneumothorax,6 meconium aspiration syndrome7 or congenital pneumoniae 8. In addition to its diagnostic utility, LU can also be used to assess the need and effect of changes in respiratory care, such as prediction of bronchopulmonary dysplasia (BPD),9 weaning nasal continuous positive airway pressure,10 predicting extubation failure11 and guiding surfactant treatment 12…”

Section: Introductionmentioning

confidence: 99%

Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research

Alonso-Ojembarrena,

Ehrhardt,

Cetinkaya

et al. 2024

Arch Dis Child Fetal Neonatal Ed

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ObjectiveRegarding the use of lung ultrasound (LU) in neonatal intensive care units (NICUs) across Europe, to assess how widely it is used, for what indications and how its implementation might be improved.Design and interventionInternational online survey.ResultsReplies were received from 560 NICUs in 24 countries between January and May 2023. LU uptake varied considerably (20%–98% of NICUs) between countries. In 428 units (76%), LU was used for clinical indications, while 34 units (6%) only used it for research purposes. One-third of units had <2 years of experience, and only 71 units (13%) had >5 years of experience. LU was mainly performed by neonatologists. LU was most frequently used to diagnose respiratory diseases (68%), to evaluate an infant experiencing acute clinical deterioration (53%) and to guide surfactant treatment (39%). The main pathologies diagnosed by LU were pleural effusion, pneumothorax, transient tachypnoea of the newborn and respiratory distress syndrome. The main barriers for implementation were lack of experience with technical aspects and/or image interpretation. Most units indicated that specific courses and an international guideline on neonatal LU could promote uptake of this technique.ConclusionsAlthough LU has been adopted in neonatal care in most European countries, the uptake is highly variable. The main indications are diagnosis of lung disease, evaluation of acute clinical deterioration and guidance of surfactant. Implementation may be improved by developing courses and publishing an international guideline.

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Lung and diaphragm ultrasound as predictors of successful weaning from nasal continuous positive airway pressure in preterm infants

Nour,

El‐Rahman,

Hameed

et al. 2024

Pediatric Pulmonology

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ObjectiveAssessment of the utility of lung and diaphragm ultrasound in the prediction of successful weaning from nasal continuous positive airway pressure (NCPAP) in preterm infants.Study DesignThis prospective cohort study was conducted on preterm infants who were considered ready for weaning off NCPAP. Lung and diaphragm ultrasound were performed just before and 3 h after weaning off NCPAP. The primary outcome was to evaluate the accuracy of lung ultrasound (LUS) in predicting successful weaning from NCPAP.ResultsOut of 65 enrolled preterm infants, 30 (46.2%) were successfully weaned from NCPAP to room air. The successful weaning group had higher gestational ages, lower incidences of previous invasive mechanical ventilation, and treated hemodynamically significant patent ductus arteriosus before the trial weaning. A LUS score of ≤6, measured before discontinuation of NCPAP, exhibited a predictive sensitivity of 80% and specificity of 75% for successful weaning (Area under the curve (AUC) = 0.865, ≤.001). When the LUS score was assessed 3 h after weaning from NCPAP, a cutoff point of ≤7 predicted successful weaning with a sensitivity and specificity of 90% and 60% respectively (AUC = 0.838, p ≤ .001). The diaphragmatic thickness fraction (DTF) was significantly lower in the successful weaning group. After adjustment for various factors, LUS score remained the only independent predictor of successful weaning.ConclusionLUS score before weaning from NCPAP has a good sensitivity and specificity for predicting successful weaning from NCPAP in preterm infants. Diaphragmatic excursion and DTF were not good predictors.

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Accuracy of lung ultrasound in predicting extubation failure in neonates: A systematic review and meta‐analysis

Cited by 7 publications

References 45 publications

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

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

Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research

Lung and diaphragm ultrasound as predictors of successful weaning from nasal continuous positive airway pressure in preterm infants

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