Neonatal lung ultrasound and surfactant administration: a pragmatic, multicenter study

Chest. 2021 Jul 19:S0012-3692(21)01354-4. doi: 10.1016/j.chest.2021.06.076. Online ahead of print.ABSTRACTBACKGROUND: Previous research shows that a lung ultrasound score (LUS) can anticipate CPAP failure in neonatal respiratory distress syndrome.RESEARCH QUESTION: Can LUS also predict the need for surfactant replacement?STUDY DESIGN AND METHODS: Multicenter, pragmatic study on preterm neonates who underwent lung ultrasound at birth and those given surfactant by masked physicians were also scanned within 24 hours from administration. Clinical data and respiratory support variables were recorded. Accuracy of LUS, SatO2/FiO2, FiO2 and Silverman score for surfactant administration were evaluated using receiver operating curves. The simultaneous prognostic value of LUS and SatO2/FiO2 for surfactant administration, adjusting for gestational age, were analyzed through logistic regression model.RESULTS: Two hundred forty infants were enrolled. One-hundred eight received at least one dose of surfactant. LUS predicted the first surfactant administration with an area under the curve (AUC) = 0.86 (95%CI 0.81-0.91) cut-off=9 Sensitivity=0.79 (95% CI, 0.70; 0.86), Specificity=0.83 (95% CI, 0.76; 0.89), Positive Predictive Value =0.79 (95% CI, 0.71; 0.87), Negative Predictive Value=0.82 (95% CI, 0.75; 0.89), Likelihood Ratio +=4.65 (95% CI, 3.14; 6.89), and Likelihood Ratio -= 0.26 (95% CI, 0.18; 0.37). No significant difference was shown among different gestational age (GA) groups: 25-27 ...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research