Lung ultrasound score and diuretics in preterm infants born before 32 weeks: A pilot study

Almudena Alonso‐Ojembarrena; Alfonso María Lechuga‐Sancho; Patricia Morales‐Arandojo; Silvia Acuñas‐Soto; Rosa López‐de‐Francisco; Simón Pedro Lubián‐López

doi:10.1002/ppul.25098

Pediatric pneumonia (PedPne) lung ultrasound score and inflammatory markers: A pilot study

Pediatric Pulmonology ◽

10.1002/ppul.25760 ◽

2021 ◽

Author(s):

Ioana Mihaiela Ciuca ◽

Mihaela Dediu ◽

Pop Liviu Laurentiu

Keyword(s):

Pilot Study ◽

Inflammatory Markers ◽

Lung Ultrasound ◽

Pediatric Pneumonia ◽

Ultrasound Score

LUNG ULTRASOUND SCORE AND DIURETICS IN PRETERM INFANTS BORN BEFORE 32 WEEKS

10.22541/au.159110351.10511675 ◽

2020 ◽

Author(s):

Almudena Alonso Ojembarrena ◽

Alfonso Mar a Lechuga Sancho ◽

Patricia Morales Arandojo ◽

Silvia Acu as Soto ◽

Rosa L pez de Francisco ◽

...

Keyword(s):

Preterm Infants ◽

Lung Ultrasound ◽

Ultrasound Score

Lung ultrasound is useful in oncohematologic patients with respiratory dysfunction admitted to an Intensive Care Unit (ICU): a pilot study

Medical Ultrasonography ◽

10.11152/mu-2332 ◽

2020 ◽

Vol 22 (2) ◽

pp. 1780182

Author(s):

Cecilia Gomez Ravetti ◽

Thiago Braganca Lana Silveira Ataide ◽

Lidia Miranda Barreto ◽

Fabricio De Lima Bastos ◽

Angelica Gomide dos Reis Gomes ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pilot Study ◽

Lung Ultrasound ◽

Respiratory Dysfunction ◽

Icu Admission ◽

Immunosuppressed Patients ◽

Show Difference ◽

Ultrasound Score ◽

B Lines

Aims: This pilot study aimed to evaluate the usefulness of a sequential lung ultrasound score (LUS) in immunosuppressed patients with oncohematologic diseases and acute respiratory dysfunction hospitalized in an intensive care unit (ICU).Materials and methods: LUS was calculated at ICU admission, after 24 h, 48 h and at discharge. A score ranging from 0 to 26 was attributed according to the number of B lines, presence of lung consolidation and pleural effusion.Results: Twenty-six patients were included. The median age was 50 years [interquartile range (IQR) 21] and 14 (54%) were male. LUS on the day of ICU admission was significantly higher in non-survivors compared to survivors (13 [5] vs 9 [9], respectively; p=0.047). The median delta LUS (LUS_D2 – LUS_D1) did not show difference between survivors and non-survivors (2 [0-7.5] vs 1 [-1.5 – 5], p=0.33). Among patients initially submitted to noninvasive mechanical ventilation (NIMV), no difference in LUS at inclusion or after 24 h was found between those who succeeded or failed on this support.Conclusion: The use of LUS to quantify lung aeration loss in oncohematologic patients hospitalized in an ICU due to acute respiratory dysfunction might be a helpful tool to predict the severity of the illness.

The Value of Lung Ultrasound Score Predicts the Ventilator use in Preterm with Dyspnea within 24h after Hospitalization

10.21203/rs.3.rs-1203352/v1 ◽

2022 ◽

Author(s):

lihua zhang ◽

jinnan Feng ◽

di jin ◽

zekun yu ◽

mingyang qu ◽

...

Keyword(s):

Preterm Infants ◽

Sensitivity And Specificity ◽

Area Under Curve ◽

Lung Ultrasound ◽

Respiratory Support ◽

Good Reliability ◽

Non Invasive ◽

Mcnemar Test ◽

Kappa Value ◽

Ultrasound Score

Abstract This study aims to explore the predictive value of LUSsc(Lung Ultrasound Score) in the selection of respiratory support mode for premature infants with dyspnea.We prospectively included 857 preterm infants and performed LU in the first 2 hours of admission and scored LUSsc by two specialist sonographers. They were divided into two stratification according to gestational age (<32 +0 weeks and 32 +0 -36+6 weeks), and had two main outcomes: invasive and non-invasive respiratory support. In the training set, analysis the clinical factors finding the best cut-off value of lung ultrasound score then verified the consistency in the verification set. The choice of invasive respiratory support is based on neonatal mechanical ventilation rules. Preterm infants with invasive respiratory support had higher LUS scores and lower OI 、birth weight、than those with non-invasive support. For preterm <32 +0 weeks the cut-off point of LUSsc was 6.5 that the area under curve was 0.749 (95% CI: 0.689-0.809), which was statistically significant (P<0.05), and the sensitivity and specificity were 74.0% and 68.3%, for preterm 32 +0 -36 +6 weeks, cut-off point was 6.5 and the area under curve was 0.863 (95% CI: 0.811-0.911), sensitivity and specificity were 75.3% and 0.836%.In the validation set, use actual clinical respiratory support selection results to verify, for preterm <32 +0 weeks (Kappa value 0.660, P<0.05, McNemar test P ＞0.05),for preterm 32 +0 -36 +6 weeks (Kappa value 0.779, P<0.05, McNemar test P ＞0.05). Conclusion: The LUS score shows good reliability to predict respiratory support mode for preterm infants with dyspnea

Can lung ultrasound score accurately predict the need for surfactant replacement in preterm neonates? A systematic review and meta-analysis protocol

PLoS ONE ◽

10.1371/journal.pone.0255332 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255332

Author(s):

Letizia Capasso ◽

Daniela Pacella ◽

Fiorella Migliaro ◽

Daniele De Luca ◽

Francesco Raimondi

Keyword(s):

Systematic Review ◽

Preterm Infants ◽

Lung Ultrasound ◽

Meta Analysis ◽

Secondary Outcome ◽

Preterm Neonates ◽

Surfactant Replacement ◽

Registration Number ◽

Ultrasound Score ◽

Long Term Prognosis

Respiratory distress syndrome (RDS) is a leading cause of morbidity and mortality in preterm infants due to primary surfactant deficiency. Surfactant replacement has greatly improved the short and long term prognosis of RDS but its administration criteria remain uncertain. Lung ultrasound has been recently shown as a non-invasive, repeatable, bedside tool to estimate parenchymal aeration using a semiquantitative score (LUS). The objective of this systematic review and meta-analysis is to evaluate the accuracy of LUS, assessed on the first day of life, to predict surfactant replacement. Methods will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and the protocol has been registered in PROSPERO database (registration number: CRD42021247888). Primary outcome: in a population of preterm infants, LUS will be compared in neonates who received surfactant replacement versus those who did not. Secondary outcome will be the accuracy of lung ultrasound score to predict the need for ≥ 2 doses of surfactant.

Lung ultrasound score as a tool to monitor disease progression and detect ventilator-associated pneumonia during COVID-19-associated ARDS

Heart & Lung ◽

10.1016/j.hrtlng.2021.05.003 ◽

2021 ◽

Author(s):

Auguste Dargent ◽

Emeric Chatelain ◽

Salim Si-Mohamed ◽

Marie Simon ◽

Thomas Baudry ◽

...

Keyword(s):

Disease Progression ◽

Lung Ultrasound ◽

Ventilator Associated Pneumonia ◽

Ultrasound Score

Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

Healthcare ◽

10.3390/healthcare9080994 ◽

2021 ◽

Vol 9 (8) ◽

pp. 994

Author(s):

Hanne Lademann ◽

Karl Abshagen ◽

Anna Janning ◽

Jan Däbritz ◽

Dirk Olbertz

Keyword(s):

Pilot Study ◽

Preterm Infants ◽

Perinatal Asphyxia ◽

Psychomotor Development ◽

Long Term Outcomes ◽

Term Outcome ◽

Long Term Outcome ◽

Developmental Index ◽

Mental Developmental Index

Therapeutic hypothermia (THT) is the recommended treatment for neuroprotection in (near) term newborns that experience perinatal asphyxia with hypoxic-ischemic encephalopathy. The benefit of THT in preterm newborns is unknown. This pilot study aims to investigate long-term outcomes of late preterm asphyctic infants with and without THT compared to term infants. The single-center, retrospective analysis examined medical charts of infants with perinatal asphyxia born between 2008 and 2015. Long-term outcome was assessed using the Bayley Scales of Infant Development 2 at the age of (corrected) 24 months. Term (n = 31) and preterm (n = 8) infants with THT showed no differences regarding their long-term outcomes of psychomotor development (Psychomotor Developmental Index 101 ± 16 vs. 105 ± 11, p = 0.570), whereas preterm infants had a better mental outcome (Mental Developmental Index 105 ± 13 vs. 93 ± 18, p = 0.048). Preterm infants with and without (n = 69) THT showed a similar mental and psychomotor development (Mental Developmental Index 105 ± 13 vs. 96 ± 20, p = 0.527; Psychomotor Developmental Index 105 ± 11 vs. 105 ± 15, p = 0.927). The study highlights the importance of studying THT in asphyctic preterm infants. However, this study shows limitations and should not be used as a basis for decision-making in the clinical context. Results of a multicenter trial of THT for preterm infants (ID No.: CN-01540535) have to be awaited.

Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study

Intensive Care Medicine Experimental ◽

10.1186/s40635-020-00367-3 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Micah L. A. Heldeweg ◽

Jorge E. Lopez Matta ◽

Mark E. Haaksma ◽

Jasper M. Smit ◽

Carlos V. Elzo Kraemer ◽

...

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Lung Ultrasound ◽

Composite Endpoint ◽

Pulmonary Involvement ◽

Chest Ct ◽

Secondary Outcome ◽

Icu Stay ◽

Academic Hospitals ◽

Ultrasound Score

Abstract Background Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. Methods Adult patients with COVID-19 pneumonia admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death or ICU stay > 30 days were recorded. Lung ultrasound and CT images were quantified as a lung ultrasound score involvement index (LUSI) and CT severity involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints. Results We included 55 ultrasound examinations in 34 patients, which were 88% were male, with a mean age of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r = 0.795), with an overall 15% bias, and limits of agreement ranging − 40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor. Conclusions Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease, and predict death or ICU stay > 30 days. Trial registration: NTR, NL8584. Registered 01 May 2020—retrospectively registered, https://www.trialregister.nl/trial/8584

Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis

BMC Anesthesiology ◽

10.1186/s12871-021-01396-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stephanie-Susanne Stecher ◽

Sofia Anton ◽

Alessia Fraccaroli ◽

Jeremias Götschke ◽

Hans Joachim Stemmler ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Lung Ultrasound ◽

Clinical Course ◽

Point Of Care ◽

Clinical Deterioration ◽

Normal Lung ◽

Icu Patients ◽

Standardized Protocol ◽

Ultrasound Score

Abstract Background Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome. Methods We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group. Results The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559). Conclusions LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.

Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211132 ◽

2021 ◽

pp. 1-13

Author(s):

Ying-Hua Sun ◽

Lin Yuan ◽

Yang Du ◽

Jian-Guo Zhou ◽

Sam Bill Lin ◽

...

Keyword(s):

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Neonatal Intensive Care ◽

Lung Ultrasound ◽

Imaging Method ◽

Chronic Lung Diseases ◽

Pleural Line ◽

Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P < 0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P < 0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.