Zong Haifeng, Lin Bingchun, Huang Yingsui, Huang Yichu, Sun Hongyan, Xu Qingling, Lin Zile, Wu Jiamin, Yang Chuanzhong
Neonatal Intensive Care Unit, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, Guangdong Province, China.
Women and Children's Medical Center, Southern Medical University, Shenzhen, 518028, Guangdong Province, China.
J Perinatol. 2025 Jan 14. doi: 10.1038/s41372-024-02206-9.
The aim of this study was to examine the predictive value of the lung ultrasound score (LUS) for successful extubation in preterm infants born at ≤25 weeks.
This was a single-center, prospective cohort study. Preterm infants with gestational age (GA) ≤ 25 weeks who received invasive mechanical ventilation (IMV) for ≥72 h were included. Lung ultrasound was performed every day. Multivariate logistic regression analysis was used to evaluate factors that predict extubation outcomes.
Ninety-three infants with GA ≤ 25 weeks were included. The mean GA was 24.5 ± 1.2 weeks. Extubation failure occurred in 55 (59.1%) neonates, and success occurred in 38 (40.9%) neonates. The LUS was significantly lower in the successful group than in the failed group (24.0 ± 2.5 vs. 32.1 ± 3.1 p < 0.001). Logistic regression analysis showed that LUS was an independent predictor of successful extubation (odd ratio 0.15 [95% CI 0.045-0.508], P = 0.002). The area under the receiver operating characteristic curve was 0.98 (p < 0.001) for LUS, and a cutoff value of ≥ 28 had 94.6% sensitivity and 92.7% specificity in detecting extubation failure.
The LUS has good accuracy for predicting successful extubation in extremely preterm infants with GA ≤ 25 weeks.
本研究旨在探讨肺超声评分（LUS）对孕周≤25周的早产儿成功拔管的预测价值。
这是一项单中心前瞻性队列研究。纳入孕周（GA）≤25周且接受有创机械通气（IMV）≥72小时的早产儿。每天进行肺部超声检查。采用多因素逻辑回归分析评估预测拔管结局的因素。
纳入93例GA≤25周的婴儿。平均GA为24.5±1.2周。55例（59.1%）新生儿拔管失败，38例（40.9%）新生儿拔管成功。成功组的LUS显著低于失败组（24.0±2.5 vs. 32.1±3.1，p<0.001）。逻辑回归分析显示，LUS是成功拔管的独立预测因素（比值比0.15 [95%CI 0.045 - 0.508]，P = 0.002）。LUS的受试者工作特征曲线下面积为0.98（p<0.001），截断值≥28时，检测拔管失败的灵敏度为94.6%，特异度为92.7%。
LUS对预测GA≤25周的极早产儿成功拔管具有良好的准确性。
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