Neonatal Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain.
Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain.
Neonatology. 2022;119(5):558-566. doi: 10.1159/000525187. Epub 2022 Jul 6.
The lung ultrasound score (LUS) has been suggested to predict moderate-severe bronchopulmonary dysplasia (msBPD) in preterm infants. We aimed to assess LUS evolution after birth in preterm infants and the effect of gestational age.
This multicentre prospective observational study was performed with newborns born before 33 weeks of gestation. We created two groups: group 1 (23-27 weeks) and group 2 (28-32 weeks). We compared LUSs between the groups from birth until 36 weeks of postmenstrual age, and we estimated the LUS evolution in each group with a linear multilevel mixed-effects regression model. The effects of the need for surfactant or an msBPD diagnosis were also studied.
We included 339 patients: 122 (36%) in group 1 and 217 (64%) in group 2. The infants in group 1 showed a steady progression in the LUS from birth until 4 weeks of age and a subsequent decrease; the infants in group 2 showed a progressive decrease in the LUS throughout the study. This progression varied significantly in the first weeks of life in infants who required surfactant at birth and after the first week of life in the patients diagnosed with msBPD.
DISCUSSION/CONCLUSIONS: Extremely preterm infants showed persistently high LUSs during the first weeks of life, regardless of the progression to msBPD. In this group, the infants who did not require surfactant at birth exhibited an increase in their LUSs after the first week until their values were equal to the remaining infants in their group.
肺部超声评分（LUS）已被用于预测早产儿中中重度支气管肺发育不良（msBPD）。本研究旨在评估早产儿出生后的肺部超声评分演变情况及其与胎龄的关系。
这是一项多中心前瞻性观察性研究，研究对象为胎龄<33 周的新生儿。我们创建了两个组：第 1 组（23-27 周）和第 2 组（28-32 周）。我们比较了两组新生儿从出生到出生后 36 周的肺部超声评分，并使用线性多水平混合效应回归模型来估计每组的肺部超声评分演变情况。还研究了是否需要表面活性剂或 msBPD 诊断的影响。
共纳入 339 例患者：第 1 组 122 例（36%），第 2 组 217 例（64%）。第 1 组的婴儿从出生到 4 周龄时肺部超声评分呈持续升高趋势，随后逐渐下降；第 2 组的婴儿在整个研究期间肺部超声评分逐渐下降。在出生时需要表面活性剂的婴儿的生命的前几周以及在被诊断为 msBPD 的婴儿的第一周后，这种进展在生命的最初几周内有显著差异。
讨论/结论：极早产儿在生命的最初几周内肺部超声评分持续较高，无论是否进展为 msBPD。在这组中，出生时不需要表面活性剂的婴儿在第一周后其肺部超声评分增加，直到其值与组内其余婴儿相等。
