Alonso-Ojembarrena Almudena, Moreno-Vargas Victor, Gutierrez-Rosa Irene, Segado-Arenas Antonio, Nemes Alexandra Floriana
Neonatal Intensive Care Unit, Puerta del Mar University Hospital, Avenida Ana de Viya 21, 11010, Cádiz, Spain.
Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, Cadiz, Spain.
Eur J Pediatr. 2025 Aug 1;184(8):521. doi: 10.1007/s00431-025-06366-4.
An increase in FiO₂ requirements at 2 weeks is related to worse respiratory prognosis in very low birth weight infants (VLBWI). We aimed to analyze the evolution in lung ultrasound (LUS) score of infants with or without this deterioration. We categorized 104 neonates born before 30 weeks' gestational age (GA) according to their initial FiO₂ progression into three groups and performed LUS at birth, at 3 days, at 1 and 2 weeks of life. The infants with low FiO2 in the first days of life (groups 1 and 2) showed low LUS score at birth, but those VLBWI with an increase in FiO2 at 2 weeks (group 2) showed an increase in LUS score since 3 days, to values similar to those with higher FiO2 since birth (group 3). This increase remained significant after adjusting for GA at day 7.
LUS score is able to detect respiratory deterioration earlier than FiO2 in VLBWI.
• Very low birth weight infants that suffer a deterioration in their respiratory status at 2 weeks of life have worse respiratory outcomes.
• Before these infants face an increase in FiO2, there is an increase in lung ultrasound score at the first week of life.
出生体重极低的婴儿（VLBWI）在出生2周时对吸入氧分数（FiO₂）需求增加与更差的呼吸预后相关。我们旨在分析有或无这种病情恶化的婴儿肺部超声（LUS）评分的变化情况。我们将104例孕龄小于30周的新生儿根据其初始FiO₂进展情况分为三组，并在出生时、出生3天、出生1周和2周时进行肺部超声检查。出生后最初几天FiO₂较低的婴儿（第1组和第2组）在出生时LUS评分较低，但2周时FiO₂增加的极低出生体重儿（第2组）自3天起LUS评分增加，至与出生后FiO₂较高的婴儿（第3组）相似的值。在出生后第7天校正孕龄后，这种增加仍然显著。
在极低出生体重儿中，肺部超声评分比FiO₂能更早地检测到呼吸功能恶化。
•出生体重极低的婴儿在出生2周时呼吸状况恶化，其呼吸结局更差。
•在这些婴儿FiO₂增加之前，出生后第一周肺部超声评分就已升高。
