Mohamed Adel, Mohsen Nada, Ibrahim Jenna, Lee Seungwoo, Kharrat Ashraf, Shah Prakesh S, Jain Amish
Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, M5G 1X5, Canada.
Eur J Pediatr. 2025 May 20;184(6):348. doi: 10.1007/s00431-025-06186-6.
Recent studies suggested lung ultrasound (LU) as a useful, non-invasive bedside tool for assessing pulmonary edema; however, its utility in identifying preterm neonates with large patent ductus arteriosus (L-PDA) is limited. The objective of the study is to evaluate the association of LU score (LUS) in preterm neonates with L-PDA during the transitional period and explore correlation of LUS with echocardiographic indicators. Among 152 neonates born < 29 weeks' gestation and had LU performed at day-of-life (DOL) three for a previous prospective study, 54 neonates had concomitant echocardiography (Echo) documenting PDA presence, diameter, and variables for shunt volume. We included in the analysis neonates who had LU and Echo on DOL 3. Neonates with L-PDA were compared to those with absent or small PDA. Univariate, multivariate, and Pearson's correlation coefficients analyses were conducted. Of the 54 infants included in the study, 32 (59%) were diagnosed with L-PDA. There were no significant differences in baseline characteristics between the L-PDA and no-L-PDA group. Univariate analysis showed no association between LUS and L-PDA. Similarly, multivariate analysis found that a one-point increment of LUS was not associated to L-PDA (adjusted OR 1.19; 95% CI 0.89-1.59). LUS demonstrated a significant correlation with respiratory severity score and a weak correlation with PDA diameter, but no significant associations with other PDA shunt volume variables.
In this cohort, LUS was not associated with L-PDA during the transition period. Larger studies are required to confirm these findings and further explore the clinical utility of LUS in assessing PDA.
• Lung ultrasound (LUS) is a non-invasive tool for assessing pulmonary edema in preterm neonates. • Previous studies have reported a positive correlation between LUS score and hemodynamically significant PDA.
• In this cohort of preterm neonates 29 weeks, LUS was not associated with large PDA during the transitional period (DOL 3). • LUS showed correlation with respiratory severity but not with echocardiographic markers of PDA shunt volume.
近期研究表明，肺部超声（LU）是评估肺水肿的一种有用的非侵入性床边工具；然而，其在识别患有大型动脉导管未闭（L-PDA）的早产儿方面的效用有限。本研究的目的是评估过渡期早产儿L-PDA的LU评分（LUS）之间的关联，并探讨LUS与超声心动图指标的相关性。在152例孕周小于29周且在出生当日（DOL）3进行过LU检查的早产儿中，54例同时进行了超声心动图（Echo）检查，记录了动脉导管未闭的存在、直径及分流体积变量。我们纳入了在DOL 3进行了LU和Echo检查的新生儿。将患有L-PDA的新生儿与未患或患有小型PDA的新生儿进行比较。进行了单因素、多因素和Pearson相关系数分析。在纳入研究的54例婴儿中，32例（59%）被诊断为L-PDA。L-PDA组和无L-PDA组的基线特征无显著差异。单因素分析显示LUS与L-PDA之间无关联。同样，多因素分析发现LUS增加1分与L-PDA无关（校正OR 1.19；95%CI 0.89-1.59）。LUS与呼吸严重程度评分显著相关，与PDA直径弱相关，但与其他PDA分流体积变量无显著关联。
在该队列中，过渡期LUS与L-PDA无关。需要更大规模的研究来证实这些发现，并进一步探讨LUS在评估PDA中的临床效用。
• 肺部超声（LUS）是评估早产儿肺水肿的非侵入性工具。• 既往研究报道LUS评分与血流动力学显著的PDA之间存在正相关。
• 在这个孕周小于29周的早产儿队列中，过渡期（DOL 3）LUS与大型PDA无关。• LUS与呼吸严重程度相关，但与PDA分流体积的超声心动图标记物无关。
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