Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
Department of Pediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, ON, M5G 1X5, Canada.
Eur J Pediatr. 2024 May;183(5):2123-2130. doi: 10.1007/s00431-024-05464-z. Epub 2024 Feb 16.
Recent research links early weight changes (EWC) with bronchopulmonary dysplasia (BPD) in preterm neonates, while lung ultrasound score (LUS) has shown promise in predicting BPD. We aimed to explore the correlation between LUS and EWC as markers of extravascular lung edema and to investigate the correlation between LUS and EWC in preterm infants with respiratory distress syndrome regarding future BPD development. This secondary analysis of a prospective study involved infants ≤ 28 weeks gestation. Enrolled infants underwent lung ultrasound assessment on postnatal days 3, 7 and 14, measuring LUS. EWC was computed on the same time points. Infants were classified as either having BPD or not. Descriptive statistics, correlation coefficient, and area under the receiver operating characteristic (AUROC) curve analysis were utilized. Of 132 infants, 70 (53%) had BPD. Univariate analysis revealed statistically significant differences in LUS and EWC at days 3, 7, and 14 between BPD and no-BPD groups (p < 0.001). A statistically significant but weak positive correlation existed between LUS and EWC (r0.37, r0.29, r0.24, and p < 0.01) at postnatal days 3, 7, and 14, respectively. AUROC analysis indicated LUS having superior predictive capacity for the need for invasive mechanical ventilation at day 14 as well as the later BPD development compared to EWC (p < 0.0001).
In a cohort of extreme preterm infants, our study revealed a positive yet weak correlation between LUS and EWC, suggesting that EWC was not the major contributing to the evolving chronic lung disease.
• Recent evidence links Early Weight-Changes with bronchopulmonary dysplasia in preterm neonates. • Lung ultrasound score has shown promise in early prediction of the subsequent development of bronchopulmonary dysplasia in preterm infants. No studies have examined the correlation between Early Weight-Changes and Lung ultrasound score in preterm infants during first 2 weeks after birth.
• Our study demonstrated a positive and statistically significant correlation between early LUS and EWC, indicating their potential role as early predictors for the subsequent development of BPD in extreme preterm infants. • The weak correlation between the two parameters may stem from the possible restricted influence of EWC, given that it may not be the primary factor contributing to the evolving chronic lung disease.
探讨肺超声评分（LUS）与早期体质量变化（EWC）作为血管外肺水标志物的相关性，并分析 LUS 与呼吸窘迫综合征早产儿未来发生支气管肺发育不良（BPD）的相关性。
前瞻性研究的二次分析，纳入胎龄≤28 周的早产儿。生后第 3、7、14 天行肺部超声检查，测量 LUS；同时计算 EWC。根据是否发生 BPD 将患儿分为 BPD 组和非 BPD 组。
描述性统计分析、相关系数、受试者工作特征（ROC）曲线下面积（AUROC）分析。
共纳入 132 例患儿，其中 70 例（53%）发生 BPD。单因素分析显示，BPD 组和非 BPD 组在生后第 3、7、14 天的 LUS 和 EWC 差异均有统计学意义（P<0.001）。生后第 3、7、14 天 LUS 与 EWC 呈弱正相关（r 值分别为 0.37、0.29、0.24，P<0.01）。ROC 分析显示，LUS 对第 14 天需要有创机械通气和之后发生 BPD 的预测能力优于 EWC（P<0.0001）。
在极早产儿队列中，本研究显示 LUS 与 EWC 之间呈正相关，但相关性较弱，提示 EWC 不是导致慢性肺部疾病进展的主要因素。
