Mohamed Adel, Mohsen Nada, Diambomba Yenge, Lashin Asem, Louis Deepak, Elsayed Yasser, Shah Prakesh S
Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, Mansoura University, Mansoura, Egypt.
J Pediatr. 2021 Nov;238:187-192.e2. doi: 10.1016/j.jpeds.2021.06.079. Epub 2021 Jul 6.
To evaluate the diagnostic and predictive ability of lung ultrasound at 3 time points in the first 2 weeks after birth for predicting bronchopulmonary dysplasia (BPD) among infants <29 weeks of gestational age.
This was a prospective, diagnostic cohort study. Lung ultrasound was performed on days 3, 7, and 14 after birth and lung ultrasound scores (LUS) were calculated in blinded fashion. Diagnostic test characteristics and area under receiver operating characteristic (AUROC) curves were calculated.
A total of 152 infants were enrolled with mean (SD) gestational age of 25.8 (1.5) weeks gestation. Of them, 87 (57%) infants were diagnosed with BPD. The LUS were significantly higher in infants diagnosed with BPD compared with those without BPD at all scan time points (P < .01). The score of >10 at all 3 time points had higher sensitivity (0.89, 0.89, and 0.77), specificity (0.87, 0.90, and 0.92), and corresponding clinically important positive and negative likelihood ratios. The AUROC for LUS at the 3 time points were 0.96, 0.97, and 0.95 on day 3, 7, and 14, respectively. Compared with the model using clinical characteristics, LUS alone had higher AUROC (P < .05 for all 3 time points).
In this cohort, LUS in the first 2 weeks after birth had a very high predictive value for the diagnosis of BPD among infants of <29 weeks of gestation.
ClinicalTrials.govNCT04756297.
评估出生后前2周内3个时间点的肺部超声对孕周<29周婴儿支气管肺发育不良（BPD）的诊断和预测能力。
这是一项前瞻性诊断队列研究。在出生后第3天、第7天和第14天进行肺部超声检查，并以盲法计算肺部超声评分（LUS）。计算诊断试验特征和受试者操作特征曲线下面积（AUROC）。
共纳入152例婴儿，平均（标准差）孕周为25.8（1.5）周。其中，87例（57%）婴儿被诊断为BPD。在所有扫描时间点，诊断为BPD的婴儿的LUS均显著高于未诊断为BPD的婴儿（P<0.01）。在所有3个时间点，评分>10具有更高的敏感性（0.89、0.89和0.77）、特异性（0.87、0.90和0.92）以及相应的具有临床意义的阳性和阴性似然比。第3天、第7天和第14天LUS的AUROC分别为0.96、0.97和0.95。与使用临床特征的模型相比，单独的LUS具有更高的AUROC（所有3个时间点P<0.05）。
在该队列中，出生后前2周的LUS对孕周<29周婴儿BPD的诊断具有很高的预测价值。
ClinicalTrials.govNCT04756297。
