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Lung ultrasound score and diuretics in preterm infants born before 32 weeks: A pilot study
Almudena Alonso-Ojembarrena1,2, Alfonso María Lechuga-Sancho2,3,4, Patricia Morales-Arandojo2
1Neonatal Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain.
Insights
Diuretic therapy can improve lung ultrasound (LU) scores in preterm infants born before 32 weeks (PTB32W). This improvement is linked to successful weaning from respiratory support (RS) during diuretic treatment.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Medical Imaging
Background:
- Preterm infants born before 32 weeks (PTB32W) often require respiratory support (RS).
- Bronchopulmonary dysplasia (BPD) is a common complication in this population.
- Lung ultrasound (LU) is a non-invasive tool for assessing lung aeration.
Purpose of the Study:
- To investigate the effect of diuretic therapy on lung ultrasound (LU) scores in preterm infants born before 32 weeks (PTB32W).
- To determine if changes in LU scores correlate with respiratory support (RS) status after diuretic administration.
Main Methods:
- Retrospective analysis of 18 PTB32W infants receiving diuretics.
- Comparison of LU scores before and after diuretic therapy.
- Assessment of respiratory support (RS) evolution (e.g., extubation).
Main Results:
- Infants receiving diuretics showed improved LU scores post-treatment.
- Lower LU scores were observed in 'responders' compared to 'non-responders' at 2 days, 1 week, and 3 weeks after diuretics (p<0.05).
- A significant decrease in RS was noted in responders, with 78% extubated versus 11% in non-responders (p=0.02).
Conclusions:
- Diuretic therapy can lead to improved LU scores in a subset of PTB32W infants.
- The observed improvement in LU scores is associated with successful weaning from respiratory support.
- These changes occur concurrently with diuretic administration, suggesting a therapeutic effect.
Objective:
To describe if weekly determined lung ultrasound (LU) scores in preterm infants born before 32 weeks (PTB32W) change with diuretic therapy.
Design:
We included infants who received diuretics and compared LU scores according to their evolution on respiratory support (RS) before and after diuretics.
Results:
We included 18 PTB32W divided into two groups. Both groups were similar in terms of median gestational age: 26 weeks (interquartile range [IQR]: 25-28) in the responders' group and 27 weeks (IQR: 24-28) in the other. They differed, however, in the median number of days on invasive mechanical ventilation: 27 (IQR: 11-43) versus 76 (IQR: 35-117), p = .03; in addition to the number of infants with moderate-severe bronchopulmonary dysplasia: 3 (33%) versus 8 (89%), p = .025. The responders' group showed lower LU scores 2 days after diuretics, with a median LU score of 6 (IQR: 3-12) versus 14 (IQR: 12-17) in the nonresponders group, p = .03; 1 week after (3 [IQR: 0-10] versus 12 [12-12], p = .04); and 3 weeks after (5 [IQR: 3-6] versus 12 [10-15], p = .01). RS also decreased at the same time: 7 out of 9 (78%) were extubated in the responders' group, and 1 out of 9 (11%) in the nonresponders group, p = .02, and these differences remained throughout the entire follow-up.
Conclusions:
There is a group of PTB32W patients whose LU score improves after diuretics. This change appears only in those patients that can be weaned off from RS, and at the same period of time as the administration of diuretics.
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