Neonatal lung ultrasonography score after surfactant in preterm infants: A prospective observational study

Alessandro Perri, Milena Tana, Riccardo Riccardi, Rossella Iannotta, Lucia Giordano, Serena Antonia Rubortone, Francesca Priolo, Domenico V Di Molfetta, Enrico Zecca, Giovanni Vento

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To assess changes in neonatal lung ultrasonography score (nLUS) after surfactant administration in preterm infants with respiratory distress syndrome (RDS).

WORKING HYPOTHESIS: The reduction of nLUS score before (nLUSpre), 2 hours (nLUS2h), and 12 hours (nLUS12h) after surfactant administration to identify patients who will not need a second treatment.

STUDY DESIGN AND SETTING: Prospective observational study in the tertiary neonatal intensive care unit.

PATIENTS SELECTION: Forty-six preterm neonates with RDS of 32 weeks median gestational age (IQR 30-33) and mean birth weight of 1650 ± 715 g.

METHODOLOGY: Lung ultrasonography was performed before, 2 hours, and 12 hours after surfactant administration in preterm infants with RDS needing surfactant treatment. Resulting nLUS was analyzed.

RESULTS: The Wilcoxon signed-rank test demonstrated an nLUS lowering after 2 hours (P < .001) and 12 hours (P < .001) from surfactant administration. Sixteen newborns required surfactant retreatment with median gestational age of 32 weeks (IQR 29-33) and mean birth weight of 1519 ± 506 g.The receiver operating characteristic analysis for the nLUS2h yielded an area under the curve of 0.80 (95% confidence interval, 0.76-0.85; P < .001). A nLUS2h ≥7 showed a sensitivity of 94% and a specificity of 60% for needing a second treatment with surfactant.

CONCLUSIONS: In preterm infants with RDS requiring surfactant treatment, nLUS evaluated 2 hours after surfactant administration can be used to identify patients who will not need a second treatment.

Original languageEnglish
Pages (from-to)116-121
Number of pages6
JournalPediatric Pulmonology
Volume55
Issue number1
DOIs
Publication statusPublished - Jan 2020

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    Perri, A., Tana, M., Riccardi, R., Iannotta, R., Giordano, L., Rubortone, S. A., Priolo, F., Di Molfetta, D. V., Zecca, E., & Vento, G. (2020). Neonatal lung ultrasonography score after surfactant in preterm infants: A prospective observational study. Pediatric Pulmonology, 55(1), 116-121. https://doi.org/10.1002/ppul.24566