Lung ultrasound (LUS) and surfactant treatment: looking for the best predictive moment

Kayki, Gozdem; Yiğit, Şule; Tandircioglu, Umit Ayse; Çelik, Hasan Tolga; Yurdakök, Murat

doi:10.1038/s41372-021-01039-0

Cited by 9 publications

(12 citation statements)

References 20 publications

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“…Nine were excluded for the following reasons: five studies reported a classification using LP 4,7,8,18,19 ; Szymansky et al 20 used a different LUS grading system which was not comparable with others; Perri et al 21 studied LUS after surfactant replacement; Raschetti et al and Rodriguez Fanjul et al investigated LUS without performing a diagnostic accuracy study (alternatively used a quality improvement, before-and-after uncontrolled and a randomized controlled design, respectively). 22,23 Finally, seven studies were included in qualitative and quantitative analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies using an LP classification (i.e., Types 1–3 grading) 4,7,8,18,19 were excluded from our primary analysis. Three of them used an LP classification within first 3 h of life to predict need for surfactant 4,8,18 and were analyzed for secondary outcomes 4,8,18 ; characteristics of studies are reported in Supporting Information: Table . All three studies enrolled preterm neonates (≤34 weeks of GA).…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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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“…LUS has been widely used in our clinic for ve years. 14,15 In this retrospective study, we observed a decrease in the number of CXRs, and thus radiation exposure, because of routine LUS use. Because no CXRs were taken in 30 babies, exposure to radiation was prevented in 28.8 of newborn infants.…”

Section: Discussionmentioning

confidence: 76%

“…Diagnosis of RDS and decision of surfactant treatment are mostly dependent on the ndings of LUS which was performed at second hours of life in this study 15 . CXRs which were taken at second hours of life were performed only to determine catheters' position, not for diagnose or treatment in patients with RDS.…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasonography Decreases Radiation Exposure in Newborns with Respiratory Distress

Tandircioglu

Yiğit

Oğuz

et al. 2021

Preprint

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Chest X-ray(CXR) is commonly used as a first line imaging method to diagnose the reason of respiratory distress in NICUs.Lung ultrasound is a new diagnostic tool for lung imaging. We aimed to determine the decrease in the number of CXRs on the first day of life in newborns with respiratory distress,with the use of lung ultrasonography. From January 2019 to June 2020,104 newborn infants hospitalized in the NICU with respiratory distress on the first day of life enrolled in this study(ClinicalTrials.govIdentifier NCT04722016).We used ultrasound as the first line technique for lung imaging.CXR was taken to determine endotracheal tube and umbilical catheter position or if considered necessary by the physician in charge of the infant.We calculated decreased number of CXR for every patient and evaluated the estimated decrease in radiation exposure. 104 neonates with median 36 weeks(25–40)gestational age and birth weight 2410gr(600–4100) enrolled in the study.Seventy(67,3%)of these babies were male.In the study group,24(23,1 %)patients were diagnosed with respiratory distress syndrome(RDS),49(47,1 %) patients with transient tachypnea of newborn(TTN),27(26 %) with pneumonia,4(3,8 %)with congenital heart diseases.Lung ultrasonography were performed 210 times for all infants,but CXRs were performed a total of only 107 times.CXR wasnot taken in 27 of the patients with a diagnosis of TTN,in 2 of the patients with a diagnosis of congenital pneumonia,and in one of the patients with congenital heart disease.The rate of patients who have never had a chest x-ray was 28,8%.Conclusions:We observed that usage of lung ultrasonography decreased the number of chest X-ray and radiation exposure in newborns with respiratory distress.

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“…The ability of LUS to scan from any direction is a significant advantage over radiography. Additionally, the LUS scoring system is considered simple, accurate, and useful in critical settings 22–24 . In this study, we investigated the relationship between LUS scores in the first 3 days of life and respiratory outcomes, including the need and duration of invasive mechanical ventilation, as well as the development of BPD.…”

Section: Discussionmentioning

confidence: 99%

Lung ultrasound scores within the first 3 days of life to predict respiratory outcomes

Aliyev,

Kayki,

Annakkaya Kocyigit

et al. 2023

Pediatric Pulmonology

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BackroundLung ultrasound (LUS) is a rapid and simple method to evaluate preterm babies with respiratory distress. Lately, LUS has also been reported as an accurate predictor for bronchopulmonary dysplasia (BPD).ObjectivesThe aim of the study was to investigate the relationship between the LUS scores within the first 3 days of life and respiratory outcomes including the need and the duration of invasive mechanical ventilation, and development of BPD.MethodsIt was a retrospective observational study. Preterm infants younger than 32 weeks were included at an academic tertiary Neonatal Intensive Care Unit between 2018 and 2023. LUS was performed within the first 3 days. Each lung was divided into three regions and defined as a score of 0 to 3 points; the total score was obtained by adding the six regional scores. LUS scores were noted in two groups as the highest and lowest scores. Statistical analyses were done to predict respiratory outcomes.ResultsTotal 218 patients were enrolled; 40, 17, and 18 infants had mild, moderate, and severe BPD, respectively. BPD did not develop in 143 patients. Within the first 3 days, the highest and lowest LUS scores significantly predicted moderate‐to‐severe BPD (p < .001) (area under receiver operating characteristic [ROC] curve, 0.684–0.913; area under ROC curve 0.647–0.902; respectively). High LUS scores were also related with the need of mechanical ventilation (p < .001). There was not a significant correlation between the duration of mechanical ventilation and the LUS scores. Regression analysis revealed that the highest LUS scores within the first 3 days of life, sepsis, and the presence of hemodynamically significant patent ductus arteriosus (hsPDA) were significantly associated with the severity of BPD.ConclusionsIn preterm babies, the LUS scores were useful to predict BPD and the need of invasive ventilation in long term. However, it was not related with the length of invasive ventilation.

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Lung ultrasound (LUS) and surfactant treatment: looking for the best predictive moment

Cited by 9 publications

References 20 publications

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

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

Lung Ultrasonography Decreases Radiation Exposure in Newborns with Respiratory Distress

Lung ultrasound scores within the first 3 days of life to predict respiratory outcomes

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