Asuka Kisho, Zuiki Masashi, Hasegawa Tomohiro, Takada Rei, Konishi Madoka, Yamano Akio, Ichise Eisuke, Hashigushi Kanae, Hasegawa Tatsuji, Iehara Tomoko
Pediatrics and Neonatology, Kyoto Prefectural University of Medicine, Kyoto, JPN.
Cureus. 2025 Jan 12;17(1):e77315. doi: 10.7759/cureus.77315. eCollection 2025 Jan.
Background Acute respiratory failure (ARF) may occur in neonates. Chest radiography is commonly used to evaluate the severity of ARF; however, the application of quantitative scales in clinical practice in neonatal intensive care units is uncommon. This study aimed to assess the usefulness of two semi-quantitative radiographical scales, the Brixia and radiographic assessment of lung edema (RALE) scores, in newborns weighing more than 1,500 g. Methods Newborns weighing > 1,500 g who received invasive respiratory support with arterial lines between January 2010 and October 2023 were enrolled in this study (n = 98; gestational age, 35.6 ± 3.1 weeks; birthweight, 2,321 ± 600 g). We investigated the correlation between the Brixia or RALE scores and the oxygen index (OI), alveolar-arterial oxygen gradient (A-aDO), and ventilation index (VI). Furthermore, the cut-off points of the two radiographic scores for the prediction of these respiratory indices were determined. Results All respiratory indices correlated with the Brixia (OI: = 0.71, 0.001; A-aDO: = 0.74, 0.001; VI: = 0.56, 0.001) and RALE scores (OI: = 0.78, 0.001; A-aDO: = 0.82, 0.001; VI: = 0.60, 0.001). Additionally, the receiver operating characteristic curve showed that the radiographical scores had a statistically significant ability to predict respiratory index values. Conclusion Brixia and RALE scores are useful predictive markers of acute respiratory failure in infants weighing >1,500 g. These chest radiography scores may be good predictors of respiratory status and have wider clinical applications in neonatal care.
背景 急性呼吸衰竭（ARF）可能发生在新生儿中。胸部X线摄影常用于评估ARF的严重程度；然而，定量量表在新生儿重症监护病房的临床实践中的应用并不常见。本研究旨在评估两种半定量放射学量表，即布里夏（Brixia）量表和肺水肿放射学评估（RALE）评分，在体重超过1500克的新生儿中的实用性。方法 纳入2010年1月至2023年10月期间接受有创呼吸支持并留置动脉导管的体重>1500克的新生儿（n = 98；胎龄，35.6±3.1周；出生体重，2321±600克）。我们研究了布里夏或RALE评分与氧合指数（OI）、肺泡-动脉氧分压差（A-aDO）和通气指数（VI）之间的相关性。此外，还确定了这两种放射学评分预测这些呼吸指标的截断点。结果 所有呼吸指标均与布里夏评分（OI：r = 0.71，P < 0.001；A-aDO：r = 0.74，P < 0.001；VI：r = 0.56，P < 0.001）和RALE评分（OI：r = 0.78，P < 0.001；A-aDO：r = 0.82，P < 0.001；VI：r = 0.60，P < 0.001）相关。此外，受试者工作特征曲线显示，放射学评分具有预测呼吸指标值的统计学显著能力。结论 布里夏和RALE评分是体重>1500克婴儿急性呼吸衰竭的有用预测指标。这些胸部X线摄影评分可能是呼吸状态的良好预测指标，在新生儿护理中具有更广泛的临床应用。
