Neonatal Lung Ultrasound and Surfactant Administration

Lung Ultrasound for the Diagnosis and Management of Neonatal Respiratory Distress Syndrome: A Minireview

“…On one hand, this LUS quality allows for estimation of the surfactant replacement therapy effect ( 11 ). On the other hand, under LUS monitoring, the need for repeated application of PS or not, the time interval of repeated application, and the dose of repeated use can be correctly determined when using PS ( 24 , 25 , 28 – 30 ).…”

Lung ultrasound scores in neonatal clinical practice: A narrative review of the literature

“…In Table 1, we summarize the main characteristics of studies that investigated the ability of LUS to predict the need of surfactant replacement therapy in infants with respiratory failure. 14,15,[20][21][22][23] Brat et al enrolled two groups of newborns, with GA < 34 or ≥34 weeks, respectively. LU was performed as soon as possible after admission of the newborn to NICU and always before administration of surfactant.…”

“…Moreover, none of the patients with a LUS ≤ 8 required surfactant treatment, suggesting that LUS can help clinicians select the correct population to treat. 14 After these monocentric studies, Raimondi et al 23 published the first multicenter trial demonstrating that a LUS ≥ 9 predicts surfactant treatment with an AUC of 0.86 (95% CI: 0.81-0.91), a sensitivity of 0.79 (95% CI: 0.70-0.86), and a specificity of 0.83 (95% CI: 15, 0.76-0.89). This A recent paper by Perri et al 21 explored changes of LUS 2 h after the first dose of surfactant (Poractant-alfa) in preterm infants with RDS.…”

Lung Ultrasound in the Neonatal Intensive Care Unit: Does It Impact Clinical Care?

“…Badurdeen et al and De Martino et al went further to show that LUS could predict the need for surfactant with more accuracy than fraction inspired oxygen (FiO 2 ) [ 42 , 43 ]. In 2021, Raimondi et al published a multicenter pragmatic trial that showed that LUS score predicted the need for surfactant (AUC 0.86), led to earlier surfactant administration, and decreased oxygen requirement in comparison to utilizing FiO 2 requirement for surfactant administration [ 44 ]. Echography-guided Surfactant THERapy (ESTHER) utilizes the LUS score to guide surfactant administration and results in an earlier administration of surfactant and a decrease in the duration of invasive ventilation without increasing cost [ 45 , 46 , 47 ].…”

“…Neonatal LUS has been evaluated for its use in predicting BPD, which would enable an earlier individualized approach to management. LUS patterns in the first four weeks after birth have been found to be a reliable predicter of BPD [ 13 , 44 , 49 , 50 ]. LUS has been shown to have a moderate accuracy at predicting BPD even as early as the third day after birth [ 14 ].…”