Loganathan P K, Meau-Petit V, Bhojnagarwala B, Nair V, Holmes J, Occhipinti A, Montasser M
Neonatal Unit, James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK.
Clinical Academic Office, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.
Eur J Pediatr. 2025 May 23;184(6):356. doi: 10.1007/s00431-025-06185-7.
Lung ultrasound (LUS) scores may predict surfactant need early and the progression of the respiratory course in preterm infants. The objective of this study is to report the diagnostic value of LUS scores performed by operators of varying levels of experience to predict the need for surfactant in preterm infants. A prospective observational study was conducted across 3 UK-based neonatal intensive care units. Preterm infants ≤ 34 weeks on non-invasive respiratory support within 3 h of birth were included. Ten lung zones were scored serially, first within the first 3 h of life, then at 12-24-h intervals (a total of four scans). All scans were performed by the local team members with formal training on LUS and varying levels of expertise. All the LUS videos were scored by an expert investigator who was blinded to clinical details. Written retrospective parental consents were obtained. We recruited 83 preterm infants ≤ 34 weeks (May 2023 to June 2024). A total of 325 LUS scans were performed by 27 clinical staff. The median birth gestational age and birth weight were 31 weeks and 1515 g, respectively. Twenty-eight (34%) babies received surfactants. The first LUS using a 6-zone method within 3 h of life predicted surfactant need and bronchopulmonary dysplasia with an AUC of 0.80 for both outcomes, offering sensitivity (79% and 73%) and specificity (75% and 76%), respectively.
LUS performed by operators of varying levels of experience within the first 3 h of life is a reliable tool for predicting surfactant need in preterm infants ≤ 34 weeks.
ClinicalTrials.gov ( https://clinicaltrials.gov/ ): NCT05782569.
• There are considerable variations in the selection criteria of preterm infants for surfactant administration. • Lung ultrasound score has been shown to predict the need for surfactant early and the progression of respiratory course in preterm infants.
• LUS performed within 3 h of life by operators of varying levels of experience and interpreted by expert predicted the need for surfactant deficiency in preterm infants. • Our research with a structured training programme enabled novice operators to perform LUS and achieve reasonable competency.
肺部超声（LUS）评分可能早期预测早产儿对表面活性剂的需求以及呼吸病程的进展。本研究的目的是报告不同经验水平的操作者进行的LUS评分对预测早产儿表面活性剂需求的诊断价值。在英国的3个新生儿重症监护病房开展了一项前瞻性观察性研究。纳入出生后3小时内接受无创呼吸支持的≤34周早产儿。对10个肺区进行连续评分，首先在出生后的前3小时内进行，然后每隔12 - 24小时进行一次（共4次扫描）。所有扫描均由接受过LUS正规培训且专业水平不同的当地团队成员进行。所有LUS视频均由对临床细节不知情的专家研究者评分。获得了家长的书面回顾性同意书。我们招募了83名≤34周的早产儿（2023年5月至2024年6月）。27名临床工作人员共进行了325次LUS扫描。出生孕周中位数和出生体重分别为31周和1515克。28名（34%）婴儿接受了表面活性剂治疗。出生后3小时内采用6区法进行的首次LUS扫描预测表面活性剂需求和支气管肺发育不良的曲线下面积（AUC）均为0.80，敏感性分别为79%和73%，特异性分别为75%和76%。
在出生后前3小时内由不同经验水平的操作者进行的LUS是预测≤34周早产儿表面活性剂需求的可靠工具。
ClinicalTrials.gov（https://clinicaltrials.gov/）：NCT05782569。
• 早产儿表面活性剂给药的选择标准存在很大差异。• 肺部超声评分已被证明可早期预测早产儿对表面活性剂的需求以及呼吸病程的进展。
• 出生后3小时内由不同经验水平的操作者进行并由专家解读的LUS可预测早产儿表面活性剂缺乏的需求。• 我们通过结构化培训计划的研究使新手操作者能够进行LUS并达到合理的能力水平。
