Neonatal lung ultrasound: From paradox to diagnosis … and beyond

Migliaro, Fiorella; Salomè, Serena; Corsini, Iuri; Luca, Danièle De; Capasso, Letizia; Gragnaniello, Diego; Raimondi, Francesco

doi:10.1016/j.earlhumdev.2020.105184

Cited by 7 publications

(17 citation statements)

References 17 publications

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“…3. we considered studies with the scoring systems including score = 0 for normal lung imaging (A lines and pleural sliding present); score = 1 for alveolar interstitial pattern (B lines not coalescent); score = 2 for severe alveolar interstitial pattern (multiple and or coalescent B lines with or without consolidations limited to subpleural space); score = 3 for extended consolidation [4,10].…”

Section: Interventionsmentioning

confidence: 99%

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Can lung ultrasound score accurately predict the need for surfactant replacement in preterm neonates? A systematic review and meta-analysis protocol

et al. 2021

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Respiratory distress syndrome (RDS) is a leading cause of morbidity and mortality in preterm infants due to primary surfactant deficiency. Surfactant replacement has greatly improved the short and long term prognosis of RDS but its administration criteria remain uncertain. Lung ultrasound has been recently shown as a non-invasive, repeatable, bedside tool to estimate parenchymal aeration using a semiquantitative score (LUS). The objective of this systematic review and meta-analysis is to evaluate the accuracy of LUS, assessed on the first day of life, to predict surfactant replacement. Methods will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and the protocol has been registered in PROSPERO database (registration number: CRD42021247888). Primary outcome: in a population of preterm infants, LUS will be compared in neonates who received surfactant replacement versus those who did not. Secondary outcome will be the accuracy of lung ultrasound score to predict the need for ≥ 2 doses of surfactant.

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Section: Interventionsmentioning

confidence: 99%

“…The original approach to neonatal lung ultrasound was purely descriptive and no score strategy was contemplated. Our group published an image classification system in 2012 [7] but Brat and coworkers adopted the numerical score for the first time in 2015 that is currently widely used [4,10].…”

Section: Information Sources and Search Strategymentioning

confidence: 99%

Can lung ultrasound score accurately predict the need for surfactant replacement in preterm neonates? A systematic review and meta-analysis protocol

et al. 2021

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“…LU has proved very capable of predicting the need for surfactant administration, and the possible need for a second dose. This would enable surfactant to be administered earlier, being this protective against bronchopulmonary dysplasia (BPD) development, and without risking overtreatment 4,5 …”

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confidence: 99%

“…This would enable surfactant to be administered earlier, being this protective against bronchopulmonary dysplasia (BPD) development, and without risking overtreatment. 4,5 In parallel, with its high power in differentiating between respiratory distress syndrome and transient tachypnea of the newborn, LU could help to reduce unnecessary intensive care admissions and treatments. 6 The diagnostic power of LU is also supported by strong evidence of its value in adult populations, in cases of pneumothorax, atelectasis, or pleural effusion, for instance.…”

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confidence: 99%

“…The importance of LU as a prognostic tool has also been growing recently. Some small studies found that a LU-based semiquantitative score could usefully and reliably predict the onset of BPD in high-risk patients, 4,7,8 and identify infants with incremented inflammatory markers. 9 In our opinion, this is a crucial feature of LU, as it can lead to a more targeted administration of corticosteroids and new drugs to contain the burden of BPD, 10 taking action promptly in high-risk patients, and avoiding doing so in those who would not benefit from such treatments.…”

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Lung ultrasound is used in neonatology for diagnostics, monitoring and prognostics, but also for prevention

Bonadies

Donà

Baraldi

2020

Pediatric Pulmonology

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Can lung ultrasound score accurately predict surfactant replacement? A systematic review and meta‐analysis of diagnostic test studies

Capasso

Pacella²,

Migliaro

et al. 2023

Pediatric Pulmonology

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Background: Clinical and radiographic criteria are traditionally used to determine the need for surfactant therapy in preterm infants. Lung ultrasound is a bedside test that offers a rapid, radiation-free, alternative to this approach.Objective: To conduct a systematic review and meta-analysis to determine the accuracy of a lung ultrasound score (LUS) in identifying infants who would receive at least one surfactant dose. Secondary aims were to evaluate the predictive accuracy for ≥2 doses and the accuracy of a different image classification system based on three lung ultrasound profiles.Methods: PubMed, SCOPUS, Biomed Central, and the Cochrane library between January 2011 and December 2021 were searched. Full articles enrolling preterm neonates who underwent lung ultrasound to predict surfactant administration were assessed and analyzed following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and QUADAS-2 guidelines.Results: Seven prospective studies recruiting 697 infants met the inclusion criteria.Risk of bias was generally low. Oxygen requirement, clinical and radiographic signs of respiratory distress syndrome were used as reference standards for surfactant replacement. The summary receiver operator characteristic (sROC) curve for LUS predicting first surfactant dose showed an area under the curve (AUC) = 0.88 (95% confidence interval [CI]: 0.82-0.91); optimal specificity and sensitivity (Youden index) were 0.83 and 0.81 respectively. Pooled estimates of sensitivity, specificity, diagnostic odds ratio, negative predictive value, and positive predictive value for LUS predicting the first surfactant dose were 0.

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Neonatal lung ultrasound: From paradox to diagnosis … and beyond

Cited by 7 publications

References 17 publications

Can lung ultrasound score accurately predict the need for surfactant replacement in preterm neonates? A systematic review and meta-analysis protocol

Can lung ultrasound score accurately predict the need for surfactant replacement in preterm neonates? A systematic review and meta-analysis protocol

Lung ultrasound is used in neonatology for diagnostics, monitoring and prognostics, but also for prevention

Can lung ultrasound score accurately predict surfactant replacement? A systematic review and meta‐analysis of diagnostic test studies

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