A Refined Score, Namely Thoracic Ultrasound Score, to Predict the Need for Surfactant in Preterm Neonates: A...

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Medical Imaging

Background:

• Lung ultrasound score (LUS) is utilized to predict surfactant requirements in preterm neonates.
• LUS demonstrates reduced efficacy in neonates with gestational age (GA) ≥ 34 weeks.
• Thoracic ultrasound score (TUS) was developed to address LUS limitations.

Purpose of the Study:

• To evaluate the feasibility and diagnostic accuracy of TUS.
• To compare TUS with LUS in assessing oxygenation and predicting surfactant needs.
• To determine TUS efficacy across different gestational age groups.

Main Methods:

• Prospective, multicenter, observational study design.
• Inclusion of preterm neonates (GA 24+0 to 36+6 weeks) on noninvasive ventilation.
• Calculation of TUS and LUS within 3 hours of life for comparison.

Main Results:

• TUS and LUS showed similar associations with S/F ratio and oxygen saturation index (OSI).
• In neonates with GA < 34 weeks, TUS and LUS had comparable predictive accuracy (AUCs: 0.956 vs. 0.952).
• In neonates with GA ≥ 34 weeks, TUS demonstrated superior predictive accuracy over LUS (AUCs: 0.971 vs. 0.797, p=0.02).

Conclusions:

• TUS is comparable to LUS in assessing oxygenation status.
• TUS exhibits superior ability in predicting surfactant needs for neonates with GA ≥ 34 weeks.
• TUS performance is similar to LUS in neonates with GA < 34 weeks.