Neonatal Med.  2019 Aug;26(3):162-168. 10.5385/nm.2019.26.3.162.

Lung Ultrasonography Score as a Respiratory Parameter of Respiratory Distress Syndrome in Very Preterm Infants: A Single Center Experience

• Sin SY
• Park JH
• Kim CS
• Lee SL

• KMID: 2457184
• DOI: http://doi.org/10.5385/nm.2019.26.3.162

Abstract

PURPOSE
Comparison between lung ultrasound (LUS) score and indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation.
METHODS
We retrospectively reviewed medical records of 32 very preterm infants born at 28 to 31 weeks' gestation at Keimyung University Dongsan Medical Center. Before surfactant administration, bedside LUS in the neonatal intensive care unit was recorded within the first hour of life. Partial pressure of capillary oxygen to fraction of inspired oxygen ratio (PcO2)/FiO2, alveolar-arterial gradient (A-aO2), modified oxygenation index (OI), and arterial to alveolar ratio were calculated. Correlation between LUS score and indices of respiratory severity were analyzed between the intubation and nasal continuous positive airway pressure (NCPAP) groups depending on the presence or absence of endotracheal intubation.
RESULTS
Mean LUS scores, A-aO2, and modified OI in the intubation group were significantly higher than those in the NCPAP group. Conversely, PcO2/FiO2 and arterial to alveolar ratios in the intubation group were significantly lower than those in the NCPAP group. LUS score was found to be significantly correlated with A-aO2 (r=0.448, P>0.05) and modified OI (r=0.453, P>0.05), but not with PcO2/FiO2 ratio (r=−0.205, P<0.05) and arterial to alveolar ratio (r=−0.190, P>0.05).
CONCLUSION
The LUS score is well correlated with indices of respiratory severity in very preterm infants born at 28 to 31 weeks' gestation. Further investigation is needed to use LUS as an alternative tool in infants with respiratory distress.

Keyword

Ultrasonography; Respiratory distress syndrome, newborn; Infant, premature

MeSH Terms

Capillaries
Continuous Positive Airway Pressure
Humans
Infant
Infant, Newborn
Infant, Premature*
Intensive Care, Neonatal
Intubation
Intubation, Intratracheal
Lung*
Medical Records
Oxygen
Partial Pressure
Pregnancy
Respiratory Distress Syndrome, Newborn
Retrospective Studies
Ultrasonography*
Oxygen

Figure

• 

  Figure 1. Relations between lung ultrasound (LUS) score and indices of respiratory severity. (A) Capillary partial pressure of oxygen (PcO2) to fraction of inspired oxygen (FiO2) ratio. (B) Alveolar-arterial gradient. (C) Modified oxygenation index. (D) Arterial to alveolar ratio. Results of correlation analysis are shown, with r indicating the crude Spearman coefficient.

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