Lung ultrasonography score versus chest X‐ray score to predict surfactant administration in newborns with respiratory distress syndrome

Perri, Alessandro; Riccardi, Riccardo; Iannotta, Rossella; Molfetta, Domenico V. Di; Arena, Roberta; Vento, Giovanni; Zecca, Enrico

doi:10.1002/ppul.24076

Cited by 66 publications

(101 citation statements)

References 29 publications

(36 reference statements)

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“…Currently, different LUS score protocols have been used to guide surfactant administration, respiratory support, and prognosis assessment . Our results suggest that the BLS is highly correlated with the PaO 2 /FiO 2 ratio, which is consistent with previous data revealing that the LUS score was significantly correlated with the oxygenation index in critical care patients .…”

Section: Discussionsupporting

confidence: 91%

“…Currently, different LUS score protocols have been used to guide surfactant administration, respiratory support, and prognosis assessment. 11,16,38 Our results suggest that the BLS is highly correlated with the PaO 2 /FiO 2 ratio, which is consistent with previous data revealing that the LUS score was significantly correlated with the oxygenation index in critical care patients. 39 These findings are also consistent with those reported by Bilotta et al 40 When the BLS ranged from 49 to 64 (infusion volume, 6-8 mL/kg) in our study, the PaO 2 /FiO 2 ratio decreased sharply ( Figure 12) but declined slowly when the BLS was < 49; these findings are in line with those of the pig model of acute lung injury induced by oleic acid, suggesting that the BLS increases before the decrease in the PaO 2 /FiO 2 ratio.…”

Section: Evlw Measurements Determined By Transpulmonary Thermodilutionsupporting

confidence: 92%

“…LUS scoring systems have been developed to meet the need for standardization and have been shown to correlate with various metrics in adults and neonates . These scoring systems are used to assess the severity, course, and prognosis of the disease and then guide the treatment . Nevertheless, it remains unclear about the degree of lung water content that can cause pulmonary dysfunction, and how to quantitatively assess lung water content by ultrasound.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12][13] These scoring systems are used to assess the severity, course, and prognosis of the disease and then guide the treatment. [14][15][16][17] Nevertheless, it remains unclear about the degree of lung water content that can cause pulmonary dysfunction, and how to quantitatively assess lung water content by ultrasound. And the correlation between B-line score (BLS) and the EVLW content is still not clear.…”

Section: Introductionmentioning

confidence: 99%

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Using lung ultrasound to quantitatively evaluate pulmonary water content

Zong

Guo

Liu

et al. 2020

Pediatric Pulmonology

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Background Increases in extravascular lung water (EVLW) can lead to respiratory failure. This study aimed to investigate whether the B‐line score (BLS) was correlated with the EVLW content determined by the lung wet/dry ratio in a rabbit model. Methods A total of 45 New Zealand rabbits were randomly assigned to nine groups. Among the animals, models of various lung water content levels were induced by the infusion of different volumes of warm sterile normal saline (NS) via the endotracheal tube. The arterial blood gas, spontaneous respiratory rate, and PaO2/FiO2 ratio were detected before and after infusion. In addition, the B‐lines were determined before and immediately after infusion in each group. Finally, both lungs were resected to determine the wet/dry ratio. In addition, all lung specimens were analyzed histologically, and EVLW was quantified using the BLS based on the number and confluence of B‐lines in the intercostal space. Results The BLS increased with increasing infusion volume. The BLS was statistically correlated with the wet/dry ratio (r2= .946) and with the PaO2/FiO2 ratio (r2= .916). Furthermore, a repeatability study was performed for the lung ultrasound (LUS) technology (Bland‐Altman plots), and the results suggest that LUS had favorable intraobserver and interobserver reproducibility. Conclusions This study is the first to suggest that the BLS can serve as a sensitive, quantitative, noninvasive, and real‐time indicator of EVLW in a rabbit model of lung water accumulation. Notably, the BLS displayed an obvious correlation with the experimental gravimetry results and could also be used to predict the pulmonary oxygenation status.

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Section: Discussionsupporting

confidence: 91%

Section: Evlw Measurements Determined By Transpulmonary Thermodilutionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Using lung ultrasound to quantitatively evaluate pulmonary water content

Zong

Guo

Liu

et al. 2020

Pediatric Pulmonology

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“…Additional, novel applications of US are being seen as well. Perri et al reported a prospective study in which lung US out‐performed chest radiographs for recognition of respiratory distress syndrome requiring surfactant administration in 56 premature newborns.…”

Section: Diagnostic Testing: Imaging and Endoscopymentioning

confidence: 99%

Pediatric Pulmonology Year in Review 2018: Rare lung disease, neuromuscular disease, and diagnostic testing

Gower

Birnkrant

Black

et al. 2019

Pediatric Pulmonology

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Pediatric Pulmonology publishes original research, case reports, and review articles on topics related to a wide range of children's respiratory disorders. In this article, we highlight the past year's publications in the topic areas of rare lung diseases, respiratory complications of neuromuscular disorders, and diagnostic testing, as well as selected literature in these areas from other journals.

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The Associations Between Lung Ultrasonography Scores in the First Day of Life and Clinical Outcomes

Güneş

Karadağ

Çakır

et al. 2021

J of Ultrasound Medicine

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Objectives-To investigate the role of lung ultrasonography (LU) in predicting noninvasive ventilation (NIV) failure and the relationship between lung ultrasonography scores (LUS) with clinical outcomes in neonatal respiratory failure (NRF).Methods-A prospective, cross-sectional study was conducted in newborns with NRF who needed NIV and were evaluated by LU. The first LUS (LUS1) was calculated at 2-6 hours and the second (LUS2) at 12-24 hours of life. The patients were divided into NIV failure and NIV non-failure groups. The relationship between LUS and clinical outcomes was evaluated.Results-Among 157 neonates, the median (interquartile range) of gestational week and birth weight were 37 weeks (34-39), and 2890 grams (2045-3435), respectively. The reasons for NRF were transient tachypnea of the newborn (n = 92, 58.6%), congenital pneumonia (n = 58, 36.9%), and respiratory distress syndrome (n = 7, 4.5%). The rate of NIV failure was 17.8% (n = 28). Both LUS1 and LUS2 were significantly higher in neonates with NIV failure compared to neonates with NIV non-failure (P = .001). A cutoff value of LUS1 ≥ 4 predicted NIV failure with 96% sensitivity and 63% specificity. There were positive correlations between LUS and PEEP values, IMV and total MV days, carbon dioxide values, length of hospital stay, and antibiotic days (ρ LUS1 , P = .

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Lung ultrasonography score versus chest X‐ray score to predict surfactant administration in newborns with respiratory distress syndrome

Abstract: LUS is a non-invasive, bedside and reproducible method that could improve the management of neonatal respiratory distress. It is accurate and reliable to early identify patients who will need treatment with surfactant allowing both an early treatment and a reduction of radiation exposure.

Cited by 66 publications

References 29 publications

Using lung ultrasound to quantitatively evaluate pulmonary water content

Using lung ultrasound to quantitatively evaluate pulmonary water content

Pediatric Pulmonology Year in Review 2018: Rare lung disease, neuromuscular disease, and diagnostic testing

The Associations Between Lung Ultrasonography Scores in the First Day of Life and Clinical Outcomes

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