Lung ultrasonography score versus chest X-ray score to predict surfactant administration in newborns with respiratory distress syndrome

Giovanni Vento, Rossella Iannotta, Enrico Zecca

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

16 Citazioni (Scopus)

Abstract

Objectives: We aim to verify the diagnostic accuracy of a lung ultrasonography (LUS) score to early predict the need for surfactant therapy in newborns with respiratory distress syndrome (RDS), and to compare it with a chest X-ray score. Methods: In this prospective diagnostic accuracy study we included all newborns admitted for respiratory distress and initially treated with nasal CPAP. LUS was performed within 2 h from nasal CPAP positioning and in any case before surfactant administration. A chest X-ray was also performed. A LUS score and an X-ray score were used and compared. Ability of the scores to predict surfactant administration was evaluated through ROC analysis. Results: In our population of 56 newborns with mean gestational age of 31 weeks (SD 3) and mean birth weight of 1442 g (SD 520), LUS score showed higher AUC than X-ray score in early recognition of infants with respiratory distress syndrome requiring surfactant treatment (0.94; 95%CI, 0.89-0.98; P < 0.001 vs 0.80; 95%CI, 0.74-0.86; P < 0.001). It showed also higher sensitivity (86% vs 82%), higher specificity (88% vs 76%), better positive (83% vs 69%), and negative (91% vs 87%) predictive values. Conclusions: LUS is a non-invasive, bedside and reproducible method that could improve the management of neonatal respiratory distress. It is accurate and reliable to early identify patients who will need treatment with surfactant allowing both an early treatment and a reduction of radiation exposure.
Lingua originaleEnglish
pagine (da-a)1231-1236
Numero di pagine6
RivistaPediatric Pulmonology
Volume53
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Echocardiography
  • Female
  • Humans
  • Infant, Newborn
  • Lung
  • Male
  • Prospective Studies
  • Pulmonary Surfactants
  • ROC Curve
  • Radiography, Thoracic
  • Respiratory Distress Syndrome, Newborn
  • Sensitivity and Specificity
  • Sepsis
  • Surface-Active Agents
  • Ultrasonography
  • X-Rays
  • lung ultrasonography
  • respiratory distress syndrome
  • surfactant therapy

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