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Updated: Sep 13, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Early evolution of lung aeration by ultrasonography in very low birth weight infants
Almudena Alonso-Ojembarrena1,2, Victor Moreno-Vargas3, Irene Gutierrez-Rosa4,5
1Neonatal Intensive Care Unit, Puerta del Mar University Hospital, Avenida Ana de Viya 21, 11010, Cádiz, Spain. almudena.alonso.sspa@juntadeandalucia.es.
Abstract:
An increase in FiO₂ requirements at 2 weeks is related to worse respiratory prognosis in very low birth weight infants (VLBWI). We aimed to analyze the evolution in lung ultrasound (LUS) score of infants with or without this deterioration. We categorized 104 neonates born before 30 weeks' gestational age (GA) according to their initial FiO₂ progression into three groups and performed LUS at birth, at 3 days, at 1 and 2 weeks of life. The infants with low FiO2 in the first days of life (groups 1 and 2) showed low LUS score at birth, but those VLBWI with an increase in FiO2 at 2 weeks (group 2) showed an increase in LUS score since 3 days, to values similar to those with higher FiO2 since birth (group 3). This increase remained significant after adjusting for GA at day 7.
Conclusion:
LUS score is able to detect respiratory deterioration earlier than FiO2 in VLBWI.
What Is Known:
• Very low birth weight infants that suffer a deterioration in their respiratory status at 2 weeks of life have worse respiratory outcomes.
What Is New:
• Before these infants face an increase in FiO2, there is an increase in lung ultrasound score at the first week of life.
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