A modified lung ultrasound score to evaluate short-term clinical outcomes of bronchopulmonary dysplasia

Sun, Yueqi; Du, Yang; Shen, Jieru; Ai, Danyang; Huang, Xiangyuan; Diao, Sihao; Lin, Sam Bill; Zhang, Rong; Lin, Yuan; Yang, Yipei; He, Lin; Qin, Xiao-Jiao; Zhou, Jianguo; Chen, Chao

doi:10.1186/s12890-022-01885-4

Cited by 10 publications

(22 citation statements)

References 44 publications

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“…Subjects were enrolled in a prospective cohort study at the Children's Hospital of Fudan University from January 2017 to December 2019. A detailed description of the cohort has been previously described elsewhere 19 . To be eligible for the modified NICHD‐defined BPD classification, the included participants needed to be born at less than 32 weeks of gestational age.…”

Section: Methodsmentioning

confidence: 99%

“…Standardized respiratory care and BPD procedures were applied in routine clinical care. The protocol was described in our previous publication 19 …”

Section: Methodsmentioning

confidence: 99%

“…Several studies have investigated whether the classic lung ultrasound (cLUS) score, including the six‐chest area, can accurately predict the diagnosis of BPD measured at 28 days of life and 36 weeks PMA, 16,17 and one meta‐analysis demonstrated that LUS can accurately predict BPD status and moderate‐to‐severe BPD in infants born at less than 32 weeks of gestation 18 . Moreover, our previous study suggested that a novel modified lung ultrasound (mLUS) score, which combines the classic six‐chest area and two‐lung base ultrasound, may be more accurate in evaluating BPD severity and other short‐term clinical outcomes compared with cLUS 19 . Sagittal scans of the liver and spleen were performed from below the lower end of the ribs using a convex probe to visualize the lung base in mLUS.…”

Section: Introductionmentioning

confidence: 99%

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Modified lung ultrasound score for bronchopulmonary dysplasia predicts late respiratory outcomes in preterm infants

Shen

Sun

et al. 2023

Pediatric Pulmonology

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ObjectiveLung ultrasound (LUS) is a useful and radiation‐free diagnostic tool for predicting bronchopulmonary dysplasia, which is a risk factor for late respiratory disease. However, data on the relationship of LUS with late respiratory disease was scarce. This study aims to determine whether LUS is associated with late respiratory disease during early childhood.MethodsThis prospective cohort study enrolled preterm infants born before 32 weeks of gestation. LUS was performed at 36 weeks' postmenstrual age. The predictive values of a modified lung ultrasound (mLUS) score based on eight standard sections were assessed to predict late respiratory disease, defined as a physician diagnosis of bronchopulmonary dysplasia deterioration, asthma, reactive airway disease, bronchiolitis, pneumonia, or respiratory‐related hospitalization during the first 2 years of life.ResultsA total of 94 infants completed follow‐up, of whom 74.5% met the late respiratory disease criteria. The mLUS scores were significantly associated with late respiratory disease (adjusted odds ratio: 1.23, CI: 1.10–1.38, p < 0.001). The mLUS scores also well predicted late respiratory disease (AUC = 0.820, 95% CI: 0.733–0.907). These scores were superior to the classic lung ultrasound score (p = 0.02) and as accurate as the modified NICHD‐defined bronchopulmonary dysplasia classification (p = 0.91). A mLUS score ≥14 was the optimal cutoff point for predicting late respiratory disease.ConclusionThe modified lung ultrasound score correlates significantly with late respiratory disease and well predicts it in preterm infants during the first 2 years of life.

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Section: Methodsmentioning

confidence: 99%

“…Standardized respiratory care and BPD procedures were applied in routine clinical care. The protocol was described in our previous publication 19 …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Modified lung ultrasound score for bronchopulmonary dysplasia predicts late respiratory outcomes in preterm infants

Shen

Sun

et al. 2023

Pediatric Pulmonology

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“…Recently, Sun et al evaluated the association between BPD severity and a modified Brat score which also included retro-hepatic and retro-splenic views obtained from subcostal scans. Although the modified score appeared to better correlate with BPD severity at 36 weeks than the classic one, its predictive capacity at 7-14 days of life was not explored (85). The two different scoring types (6 vs. 10 chest fields) have also been evaluated in a meta-analysis (84) which recommended using simpler one, since no significant betweenscores difference was detected in terms of BPD prediction.…”

Section: Lung Ultrasound Markers For Bpd Association or Predictionmentioning

confidence: 99%

A scoping review of echocardiographic and lung ultrasound biomarkers of bronchopulmonary dysplasia in preterm infants

et al. 2023

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Despite recent improvements in neonatal care, moderate to severe bronchopulmonary dysplasia (BPD) is still associated with high mortality and with an increased risk of developing pulmonary hypertension (PH). This scoping review provides an updated overview of echocardiographic and lung ultrasound biomarkers associated with BPD and PH, and the parameters that may prognosticate their development and severity, which could be clinically helpful to undertake preventive strategies. A literature search for published clinical studies was conducted in PubMed using MeSH terms, free-text words, and their combinations obtained through appropriate Boolean operators. It was found that the echocardiography biomarkers for BPD, and especially those assessing right ventricular function, are reflective of the high pulmonary vascular resistance and PH, indicating a strong interplay between heart and lung pathophysiology; however, early assessment (e.g., during the first 1–2 weeks of life) may not successfully predict later BPD development. Lung ultrasound indicating poor lung aeration at day 7 after birth has been reported to be highly predictive of later development of BPD at 36 weeks' postmenstrual age. Evidence of PH in BPD infants increases risk of mortality and long-term PH; hence, routine PH surveillance in all at risk preterm infants at 36 weeks, including an echocardiographic assessment, may provide useful information. Progress has been made in identifying the echocardiographic parameters on day 7 and 14 to predict later development of pulmonary hypertension. More studies on sonographic markers, and especially on echocardiographic parameters, are needed for the validation of the currently proposed parameters and the timing of assessment before recommendations can be made for the routine clinical practice.

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“…A recent study in 2022 reported a new prediction method based on a modified lung ultrasound score. 122 The investigators modified the classical lung ultrasound score by including sagittal scans of the liver and spleen using a convex probe from the lower end of the ribs. 1,[123][124][125][126][127] These datapoints were potentially useful because CLD affects the posterior and lower part of the lung more than the anterior region.…”

Section: Evaluation Of Chronic Lung Diseasementioning

confidence: 99%

Lung Ultrasound in Neonates: An Emerging Tool for Monitoring Critically Ill Infants

Maheshwari¹,

Suryawanshi²,

Paul³

et al. 2023

Newborn

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Context: Neonatal lung ultrasound is emerging as a useful clinical tool for the assessment of lung anatomy and management of various lung pathologies. In this review, we summarize normal lung ultrasound (LUS) findings and specific features of various lung morbidities. Evidence acquisition: A comprehensive literature search was conducted across multiple sources with relevant keywords with an additional filter of the age-group between 0 and 28 days. Findings: Apart from the description of normal newborn lungs, clinical and radiological features of a variety of lung pathologies were evaluated and incorporated in the review. Bedside LUS has evolved to be an important point-of-care imaging modality that can help in day-to-day clinical decision-making. It can be used in differentiating respiratory distress syndrome from transient tachypnea on the newborns, in the detection of pneumothorax, and in diagnosing pneumonia, pulmonary hemorrhage, and pleural effusion. Evidence supports the use of LUS scores to decide on the need for early rescue surfactant therapy with high sensitivity and specificity. Lung ultrasound scores obtained during the first 2 weeks after birth can help predict the likelihood of chronic lung disease/bronchopulmonary dysplasia. Once validated, it could be valuable for guiding early intervention and evaluation of new treatments. Conclusion: Neonatal lung ultrasound is emerging as a vital monitoring tool in critically ill infants with lung disease. It will be valuable in the early diagnosis, management, and prognosis of these patients.

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A modified lung ultrasound score to evaluate short-term clinical outcomes of bronchopulmonary dysplasia

Cited by 10 publications

References 44 publications

Modified lung ultrasound score for bronchopulmonary dysplasia predicts late respiratory outcomes in preterm infants

Modified lung ultrasound score for bronchopulmonary dysplasia predicts late respiratory outcomes in preterm infants

A scoping review of echocardiographic and lung ultrasound biomarkers of bronchopulmonary dysplasia in preterm infants

Lung Ultrasound in Neonates: An Emerging Tool for Monitoring Critically Ill Infants

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