Division of Neonatology, Department of Translational Medical Sciences and
Division of Neonatology, Department of Translational Medical Sciences and.
Pediatrics. 2021 Apr;147(4). doi: 10.1542/peds.2020-030528. Epub 2021 Mar 9.
The utility of a lung ultrasound score (LUS) has been described in the early phases of neonatal respiratory distress syndrome (RDS). We investigated lung ultrasound as a tool to monitor respiratory status in preterm neonates throughout the course of RDS.
Preterm neonates, stratified in 3 gestational age cohorts (25-27, 28-30, and 31-33 weeks), underwent lung ultrasound at weekly intervals from birth. Clinical data, respiratory support variables, and major complications (sepsis, patent ductus arteriosus, pneumothorax, and persistent pulmonary hypertension of the neonate) were also recorded.
We enrolled 240 infants in total. The 3 gestational age intervals had significantly different LUS patterns. There was a significant correlation between LUS and the ratio of oxygen saturation to inspired oxygen throughout the admission, increasing with gestational age (b = -0.002 [ < .001] at 25-27 weeks; b = -0.006 [ < .001] at 28-30 weeks; b = -0.012 [ < .001] at 31-33 weeks). Infants with complications had a higher LUS already at birth (12 interquartile range 13-8 vs 8 interquartile range 12-4 control group; = .001). In infants 25 to 30 weeks' gestation, the LUS at 7 days of life predicted bronchopulmonary dysplasia with an area under the curve of 0.82 (95% confidence interval 0.71 to 93).
In preterm neonates affected by RDS, the LUS trajectory is gestational age dependent, significantly correlates with the oxygenation status, and predicts bronchopulmonary dysplasia. In this population, LUS is a useful, bedside, noninvasive tool to monitor the respiratory status.
肺部超声评分（LUS）已在新生儿呼吸窘迫综合征（RDS）的早期阶段得到描述。我们研究了肺部超声作为一种监测早产儿 RDS 整个过程中呼吸状态的工具。
将早产儿按 3 个孕周队列（25-27 周、28-30 周和 31-33 周）分层，从出生开始每周进行一次肺部超声检查。还记录了临床数据、呼吸支持变量和主要并发症（败血症、动脉导管未闭、气胸和新生儿持续性肺动脉高压）。
我们共纳入了 240 名婴儿。这 3 个孕周组的 LUS 模式有显著差异。LUS 与整个住院期间血氧饱和度与吸入氧比值呈显著相关，随孕周增加而增加（25-27 周时 b = -0.002 [ <.001]；28-30 周时 b = -0.006 [ <.001]；31-33 周时 b = -0.012 [ <.001]）。有并发症的婴儿出生时 LUS 更高（12 个四分位间距 13-8 与 8 个四分位间距 12-4 对照组； =.001）。在 25 至 30 周胎龄的婴儿中，LUS 在 7 天时对支气管肺发育不良的预测曲线下面积为 0.82（95%置信区间 0.71 至 93）。
在患有 RDS 的早产儿中，LUS 轨迹与胎龄有关，与氧合状态显著相关，并预测支气管肺发育不良。在该人群中，LUS 是一种有用的、床边的、非侵入性监测呼吸状态的工具。
