Lung Ultrasonography Score to Evaluate Oxygenation and Surfactant Need in Neonates Treated With Continuous Positive Airway Pressure

Brat, Roselyne; Yousef, Nadya; Klifa, Roman; Reynaud, Stéphanie; Aguilera, Shivani Shankar; Luca, Danièle De

doi:10.1001/jamapediatrics.2015.1797

Cited by 329 publications

(514 citation statements)

References 29 publications

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“…We used a previously validated LUS score [13], adapted to our purpose, to monitor changes in the lung air/fluid ratio throughout the disease course. We performed follow-up LUS scans at set time intervals during the TTN course and were able to demonstrate that LUS and Silverman scores follow similar trends.…”

Section: Discussionmentioning

confidence: 99%

“…In detail, this LUS score is calculated based on 3 chest areas for each side (anterior, lateral, and posterior fields). A score of 0–3 points is given for each area according to basic LUS semiology; the total score ranges from 0 to 18 and is inversely correlated with lung aeration [13]. All LUS images were digitally recorded, anonymized and then centralized to the coordinating center, where they were reviewed by a senior independent ultrasonographer experienced in LUS (G.V.)…”

Section: Methodsmentioning

confidence: 99%

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A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Raimondi

Yousef

Fanjul³

et al. 2019

Neonatology

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Background and Aim: Discordant results that demand clarification have been published on diagnostic lung ultrasound (LUS) signs of transient tachypnea of the neonate (TTN) in previous cross-sectional, single-center studies. This work was conducted to correlate clinical and imaging data in a longitudinal and multicenter fashion. Methods: Neonates with a gestational age of 34–40 weeks and presenting with TTN underwent a first LUS scan at 60–180 min of life. LUS scans were repeated every 6–12 h if signs of respiratory distress persisted. Images were qualitatively described and a LUS aeration score was calculated. Clinical data were collected during respiratory distress. Results: We enrolled 65 TTN patients. Thirty-one (47.6%) had a sharp echogenicity increase in the lower lung fields (the “double lung point” or DLP sign). On admission, there was no significant difference between patients with and without DLP in Silverman scores (4 ± 1.5 vs. 4 ± 2.1; p = 0.9) or LUS scores (7.6 ± 2.6 vs. 5.6 ± 3.8; p = 0.12); PaO₂/FiO₂ (249 ± 93 vs. 252 ± 125; p = 0.91). All initial LUS scans (performed at the onset of distress) and 99.5% of all scans showed a regular pleural line with no consolidation, with only 1 neonate showing consolidation in the follow-up scans. The Silverman and LUS scores were significantly correlated (rho = 0.27; p = 0.02). Conclusion: A regular pleural line with no consolidation is a consistent finding in TTN. The presence of a DLP is not essential for the LUS diagnosis of TTN. A semi-quantitative LUS score correlates well with the clinical course and could be useful in monitoring changes in lung aeration during TTN.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Raimondi

Yousef

Fanjul³

et al. 2019

Neonatology

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“…The accuracy of LUS in estimating the need for surfactant or respiratory support has already been analyzed [7,19,20]. In those studies, LUS was confirmed to be a good tool for prediction of the need for MV, being even better than chest X-rays [7].…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

et al. 2016

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Background: The prognosis of neonatal respiratory distress may be difficult to estimate at admission. Lung ultrasound is a useful diagnostic tool that is quick, requires little training, and is radiation free. Objective: This study aims to analyze whether early lung ultrasound can predict respiratory failure. Methods: From January to December 2014, lung ultrasound was performed on neonates admitted with breathing difficulties if they were older than 32 weeks and not intubated. A neonatologist, not aware of the patient's clinical condition, analyzed the stored ultrasound images. The findings were classified into the following 2 groups according to the potential risk of a bad respiratory outcome: low risk (normal or transient tachypnea of the newborn) or high risk (respiratory distress syndrome, meconium aspiration syndrome, pneumothorax, or pneumonia). A second investigator made the same classification after reading the chest X-rays. Respiratory failure was defined as a need for mechanical ventilation during the first day of life. Results: In total, 105 neonates were recruited (64.8% in the low-risk sonography group and 35.2% in the high-risk sonography group). Of those, 20% needed intubation, and this was more frequent in the high-risk group (relative risk = 17.5; 95% CI 4.3-70.9, p < 0.01). As predictors of respiratory failure, lung ultrasound and chest X-ray showed a high index of agreement (κ coefficient = 0.91; 95% CI 0.83-1, p < 0.01) and good accuracy (ultrasound: 95% sensitivity, 82.5% specificity, and a negative predictive value of 98.5%). Conclusions: Early lung ultrasound is a useful tool to determine which neonates admitted with respiratory distress will require mechanical ventilation. It may help the clinician to carrying out appropriate transfers.

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“…After 28 DOL, if the patient was not on respiratory support, we would perform a LU every 2 weeks. We calculated the LU score as previously described by Brat et al by adding the score (0‐3) obtained in three areas of the thorax defined by the anterior axillary line, the posterior axillary line, and the mammary line (upper anterior, lower anterior, and lateral) with a total score range of 0 to 18.…”

Section: Methodsmentioning

confidence: 99%

“…Lung ultrasound (LU) has gained importance in the management of patients in the Neonatal Intensive Care Unit (NICU) as a safe and effective test to diagnose respiratory disease in newborns . It can be used to predict the need for respiratory support in the first hours of life or the need for surfactant administration in preterm infants . LU is reproducible and reduces the number of thoracic X‐rays performed in the NICU .…”

Section: Introductionmentioning

confidence: 99%

Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants

Alonso‐Ojembarrena

Lubián‐López

2019

Pediatric Pulmonology

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Background Lung ultrasound (LU) has been widely used to diagnose and monitor acute lung diseases in neonates, but its role in chronic diseases has not been elucidated. Objective We aim to describe the evolution of a lung ultrasound score (LU score) in very low birth weight infants (VLBWI) with and without bronchopulmonary dysplasia (BPD). Methods We prospectively included 59 VLBWI and performed LU in the first 24 and 72 hours of life, and then weekly until 36 weeks´ postmenstrual age (PMA). We calculated the LU score as a semiquantitative score representing the aeration (0‐3) in three different areas of each lung. Results The non‐BPD group (n = 38) had lower LU score at 1, 2, 3, 4, and 36 weeks' PMA than the BPD group: median score of 1 (0‐4) vs 7 (3‐10), P < .001; 0 (0‐1) vs 7 (4‐9), P < .001; 0 (0‐1) vs 8 (7‐11), P < .001; 0 (0‐2) vs 9 (4‐12), P < .001; 0 (0‐0) vs 3 (0‐6), P < .001. A LU score of 5 or above at 1 week of life predicted BPD with a sensitivity (Se) of 71%, specificity (Sp) 80%, area under the ROC curve (AUC) 0.8, and at 2 weeks of life with Se 74%, Sp 100%, and AUC 0.93. An LU score of 4 or above at 4 weeks predicted moderate‐severe BPD (Se 100%, Sp 80%, and AUC 0.89). Conclusion In VLBWI without BPD, LU score increases during the first week of life and decreases thereafter, whereas among subjects with BPD, the LU score remains high until 36 weeks´ PMA. LU score can predict the diagnosis of BPD at 1 week and 2 weeks of life, and may predict moderate‐severe BPD at 4 weeks of life.

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Lung Ultrasonography Score to Evaluate Oxygenation and Surfactant Need in Neonates Treated With Continuous Positive Airway Pressure

Cited by 329 publications

References 29 publications

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

A Multicenter Lung Ultrasound Study on Transient Tachypnea of the Neonate

Lung Ultrasound as a Predictor of Mechanical Ventilation in Neonates Older than 32 Weeks

Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants

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