肺部超声（LUS）与表面活性物质治疗：寻找最佳预测时机。
Lung ultrasound (LUS) and surfactant treatment: looking for the best predictive moment.
机构信息
Division of Neonatology, Department of Pediatrics, Hacettepe University, Ankara, Turkey.
出版信息
J Perinatol. 2021 Jul;41(7):1669-1674. doi: 10.1038/s41372-021-01039-0. Epub 2021 Mar 23.
OBJECTIVE
Assess the earliest time of LUS to guide surfactant therapy.
STUDY DESIGN
In this observational study (ClinicalTrials.gov Identifier NCT04544514), LUS was performed within 30 min and repeated at 1, 2, 4, and 6 h on preterm babies. White lung appearance was defined as type 1 group, whereas prevalence of lines B as type 2 and lines A as type 3. Ultrasound and radiographic findings were also compared to determine surfactant need.
RESULTS
Among 71 patients, 41 received surfactant therapy. In the first evaluation, 37 of them have been defined as type 1, whereas 4 of them have been as type 2 group. Type 3 group did not receive surfactant. Type 1 findings were superior to predict surfactant need and the predictive value was 100% at 2 h.
CONCLUSION
Even early LUS assessment at the first 20-30 min was more significant to predict surfactant need than x-ray. Presence of white lung appearance for 2 h indicates an absolute surfactant need.
目的
评估最早的 LUS 时间以指导表面活性剂治疗。
研究设计
在这项观察性研究（ClinicalTrials.gov 标识符 NCT04544514）中，在早产儿出生后 30 分钟内进行 LUS，并在 1、2、4 和 6 小时重复进行。白肺外观定义为 1 型组，而线 B 为 2 型，线 A 为 3 型。还比较了超声和放射学结果以确定表面活性剂的需求。
结果
在 71 名患者中，有 41 名接受了表面活性剂治疗。在第一次评估中，其中 37 名被定义为 1 型，而其中 4 名被定义为 2 型。3 型组未接受表面活性剂治疗。1 型表现优于预测表面活性剂的需求，在 2 小时时预测值为 100%。
结论
即使在最初的 20-30 分钟内进行早期的 LUS 评估，也比 X 射线更能准确预测表面活性剂的需求。白肺外观持续 2 小时表明绝对需要表面活性剂。
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