| Title: |
A Simplified, Regional Lung Ultrasound Score for Surfactant Administration in Neonatal RDS: A Prospective Observational Study |
| Authors: |
Raimondi, F; Dolce, P; Veropalumbo, C; Sierchio, E; Corsini, I; Meneghin, F; Lama, S; Raschetti, R; Varano, S; Perri, A; Bonadies, L; Alonso Ojembarrena, A; Rodriguez Fanjul, J; Gregorio Hernandez, R; Fernandez, LR; Migliaro, F; Salomè, S; Pierri, L; Dani, C; Lista, G; Mosca, F; Carnielli, V; Baraldi, E; Vento, G; Giordano, L; Sanchez Luna, M; Davis, PG; Capasso, L |
| Publisher Information: |
Wiley |
| Publication Year: |
2025 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
BACKGROUND: A total lung ultrasound score (tLUS) is a validated tool to describe parenchymal aeration, evaluate neonatal respiratory distress syndrome (RDS) progression and guide early surfactant replacement. tLUS derives from regional scores (rLUS) from predefined ultrasound views. RESEARCH QUESTION: This paper explores the relative contribution of rLUS to tLUS and their predictive power of surfactant need for RDS, individually and with additional variables. STUDY DESIGN AND METHODS: This was a secondary analysis of multicenter, prospective, observational study. Preterm neonates with RDS were stabilized on nCPAP. Within 2 h of life, we calculated a tLUS (range 0-18) by summing 6 rLUS (using a 0-3 scale on midclavicular, anterior and posterior axillary line views) and the oxygen saturation/inspired oxygen fraction ratio (SatO2/FiO2). The administration of surfactant by a physician masked to the ultrasound results was used as reference test. RESULTS: We enrolled 175 preterm infants. A midclavicular (MC) score ≥ 2 was an early marker of aeration heterogeneity. Prognostic accuracy for surfactant need was high for the left MC score (AUC: 0.86 with sensitivity 0.79 and specificity 0.90) and the right MC score (AUC 0.87 with sensitivity 0.74 and specificity 0.93; optimal Youden cut-off = 2). A combined left + right MC score lead to an AUC: 0.90 (sensitivity 0.82. specificity 0.89; optimal Youden cut-off = 3). A prediction model including gestational age, SatO2/FiO2 and the combined MC score had an AUC 0.95. INTERPRETATION: rLUS are not always uniformly distributed in early RDS. The combined MC score is a simplified rapid and accurate predictor of surfactant replacement (alone or in combination with noninvasive variables) reducing stressful manipulations in first hours of life for preterm neonates. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
8755-6863 |
| Relation: |
https://hdl.handle.net/11343/364269 |
| Availability: |
https://hdl.handle.net/11343/364269 |
| Rights: |
https://creativecommons.org/licenses/by/4.0 ; CC BY |
| Accession Number: |
edsbas.891C7D57 |
| Database: |
BASE |