Evaluation of Different Types of Natural Surfactants by Lung Ultrasound in Respiratory Distress Syndrome

Abstract

Objective To compare the lung ultrasonography (LUS) scores after two different natural surfactant administration as a parameter reflecting lung inflation. Study Design Preterm infants of 32 gestational weeks and below who were diagnosed with respiratory distress syndrome (RDS) were randomly assigned to be administered either poractant alfa or beractant, prospectively. Serial LUS scans were obtained by an experienced neonatologist in a standardized manner before and after (2 and 6 hours) surfactant administration. The LUS scans were evaluated by protocols based on scores and lung profiles. Results Thirty-seven infants received poractant alfa and 36 received beractant. The baseline characteristics and presurfactant LUS scores were similar in groups. The scores were significantly decreased after surfactant administration in both groups (2 hours, p = < 0.001; 6 hours, p = < 0.001). LUS scores in poractant group were significantly lower than beractant group when compared at each time point. At the end of 6 hours, the number of infants with the normal profile was significantly higher in the poractant group (∼65%) than the beractant group (22%). Conclusion LUS is beneficial for evaluating lung aeration after surfactant treatment in preterm infants with RDS. A better lung aeration can be achieved in the early period with the use of poractant alfa.

Lung Ultrasound Score to Predict Surfactant Administration in Premature Neonates with Respiratory Distress Syndrome: A Systematic Review and Meta-analysis

“…However, the disadvantage of the LUS is that it only provides a numerical quantitative assessment of the severity of lung lesions. It is difficult to accurately assess patients with severe and complex lesions, such as pulmonary hemorrhage, pneumothorax, and hernias; therefore, the original images should be kept for analysis and combined with CXR or even computed tomography (CT) if necessary (42,43). Additionally, evaluating lung diseases by ultrasound is closely related to the ultrasound equipment and the operator's experience.…”

Preterm yenidoğanlarda gebelik yaşına göre küçük olmak ile tiroid fonksiyon testleri arasındaki ilişki

“…Patients with surgical or severe NEC (stage >2) was recorded 19 . Patients who were given surfactant for respiratory distress were accepted as RDS 20 . A birth weight below the 10th percentile for gestational age was defined as SGA (symmetrical and asymmetrical) 4 .…”

Application of ultrasonography in neonatal lung disease: An updated review

“…In the current era, several LUS scores have been introduced as an effective predictor of the need for surfactant treatment among neonates with RDS ( 37 – 41 ). Based on the evaluation of treatment effect by LUS scores, poractant alfa produces a more favorable outcome than beractant ( 42 ), and the treatment effect of poractant alfa and beractant is superior compared with that of calfactant ( 43 ). These positive results indicate that LUS shows promise as a useful tool for decision-making during the treatment of neonatal RDS ( 44 , 45 ).…”