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

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.