Abstract:
Background
Ratio of neonatal intensive care unit (NICU) admission by respiratory distress syndrome (RDS) as a part of total NICU admission is increasing yearly with the highest increase in RDS incidence in extremely preterm neonates. Lung ultrasound (LUS) can be used in diagnosis of RDS complications with better detection, compared to Chest X-ray, of consolidation and sub-pleural atelectasis. It can be used also in follow-up and early assessment of the response to surfactant therapy.
Aim
Assess the response to early selective replacement therapy in premature neonates using lung ultrasonography and predict need for a second dose of surfactant.
Patients /Methods
Neonates ≤ 34 weeks (60 neonates) were enrolled in this study and treated with early continuous positive airway pressure (CPAP); LUS was performed in the first 2 hours of postnatal life. 16 neonates treated with surfactant replacement therapy according to European consensus guidelines 2019 update. LUS was repeated after surfactant administration within 2 hours. 7 neonates needed a second dose of surfactant.
Results
Our study shows that LUS score pre-surfactant at a cut-off value of ≥ 10 has a sensitivity of 85.7 % and specificity of 77.8 % for prediction of surfactant retreatment. LUS score post surfactant at a cut-off value of ≥ 6 has a sensitivity of 85.7 % and specificity of 88.9 %.
Conclusion
Lung ultrasound score is useful in assessment of the response to early selective surfactant therapy in preterm neonates and predicts the need for a second dose of surfactant therapy.