scholarly journals Roles of Lung Ultrasound Score in the Extubation Failure From Mechanical Ventilation Among Premature Infants With Neonatal Respiratory Distress Syndrome

2021 ◽  
Vol 9 ◽  
Author(s):  
Zhenyu Liang ◽  
Qiong Meng ◽  
Chuming You ◽  
Bijun Wu ◽  
Xia Li ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Extubation Failure ◽  
Combined Model ◽  
Internal Validation ◽  
Neonatal Respiratory Distress ◽  
Ultrasound Score

Objective: To investigate the predictive value of lung ultrasound score (LUS) in the extubation failure from mechanical ventilation (MV) among premature infants with neonatal respiratory distress syndrome (RDS).Methods: The retrospective cohort study was conducted with a total of 314 RDS newborns who received MV support for over 24 h. After extubation from MV, infants were divided into extubation success and extubation failure groups. Extubation failure was defined as re-intubation within 48 h after extubation. Univariate and multivariate logistic regression analyses were used to identify the predictors of the extubation failure. The predictive effectiveness of the combined model and LUS in the extubation failure was assessed by receiver operating characteristic curve, area under curve (AUC), and internal validation.Results: 106 infants failed extubation from MV. The combined model for predicting the extubation failure was performed according to the predictors of gestational age, body length, birth weight, and LUS. The AUC of this combined model was 0.871 (sensitivity: 86.67%, specificity: 74.31%). The AUC of LUS was 0.858 (sensitivity: 84.00%, specificity: 80.69%), and the cutoff value was 18. There was no statistical difference in the predictive power between the combined model and LUS (Z = 0.880, P = 0.379). The internal validation result showed that the AUC of LUS was 0.855.Conclusions: LUS presented a good ability in predicting the extubation failure among RDS newborns after MV.

scholarly journals Application Value of a New Lung Ultrasound Scoring Method in Neonatal Respiratory Distress Syndrome Treatment 

2020 ◽  
Author(s):  
Qiu-xia Jiang ◽  
Li-jing Shi ◽  
Long-yuan Shen ◽  
Xiao-qing Li ◽  
Rong-sen Hung ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Surfactant ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Neonatal Respiratory Distress Syndrome ◽  
Scoring Method ◽  
Neonatal Respiratory Distress ◽  
Pre Treatment

Abstract We studied a 14-zone lung ultrasound scoring method to quantify the efficiency of pulmonary surfactant treatment and to determine the timing of mechanical ventilation in neonates with neonatal respiratory distress syndrome. In this prospective study, we identified 88 neonates who received pulmonary surfactant replacement therapy. We measured surfactant efficiency using the 14-zone scoring method pre-treatment and at 12 h, 24 h, 48 h, and 72 h post-treatment. The ultrasound score was inversely associated with pulmonary surfactant treatment. We also identified 67 neonates on mechanical ventilation. We applied the scoring method when the infants met criteria for ventilator withdrawal. A comparison of pre-treatment to 12 h post-treatment showed that scoring method was significantly different (t = 4.08, P < 0.05); other scoring methods did not differ (P > 0.05). Thus, the scoring method performed better on withdrawal time. A score of 41.0 was defined as the threshold for risk of withdrawal failure with 92.36% sensitivity and 93.80% specificity, with an area under the curve of 0.955. Conclusion: The new 14-zone lung ultrasound scoring method improved scoring on the efficacy of pulmonary surfactant and had good diagnostic efficiency for timing the removal of mechanical ventilation in neonatal respiratory distress syndrome.

scholarly journals Evaluation of the Efficacy of Budesonide Combined with Pulmonary Surfactants on the Neonatal Respiratory Distress Syndrome by Pulmonary Ultrasonography

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Chuanlong Zhang
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Control Group ◽  
Ultrasound Images ◽  
Neonatal Respiratory Distress ◽  
Experimental Group ◽  
Paco2 Level

Objective. This study aimed to investigate the value of lung ultrasound images in evaluating the efficacy of budesonide combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS) in premature infants. Methods. 76 NRDS premature infants admitted to the hospital were randomly divided into experimental group and control group, with 38 children in each group. The premature infants in control group underwent PS, and those in experimental group underwent budesonide combined with PS. After treatment, lung ultrasound imaging was used to evaluate the curative effect, and X-ray results were used as a reference. The changes in clinical signs of two groups were detected, and the pulmonary ultrasound was used to evaluate the clinical efficacy of two groups. The changes in the lung ultrasound score (LUS) and arterial blood gas (ABG) indexes of two groups were compared before and after treatment. Results. LUS and improvement of patients of experimental group were obviously higher than those of the control group after treatment. LUS of experimental group was 12.1 ± 3.7, and that of control group was 18.2 ± 2.3, respectively. The differences were statistically significant ( P  < 0.05). The arterial partial oxygen pressure (PaO2) and oxygenation index (PaO2/FiO2) levels of two groups of patients increased dramatically after treatment. PaO2 and PaO2/FiO2 levels of experimental group were 65.59 ± 12.46 mmHg and 112.57 ± 19.3 mmHg, and those of control group were 45.12 ± 11.21 mmHg and 101.28 ± 21.36 mmHg, respectively. However, arterial partial pressure of carbon dioxide (PaCO2) level was significantly decreased in two groups after treatment. PaCO2 level of experimental group was 40.24 ± 8.92 mmHg, and that of control group was 41.22 ± 9.24 mmHg, respectively ( P  < 0.05). The diagnostic accuracy of lung ultrasound images in two groups was 95.3% and 96.2%, respectively. Conclusion. Pulmonary ultrasonography showed a high diagnostic accuracy in evaluating the efficacy of budesonide combined with PS in the treatment of NRDS in premature infants. It can evaluate the cardiopulmonary function of premature infants with NRDS and effectively improve the respiratory status of premature infants. In conclusion, this study provided some reference value for upgrading the clinical treatment of NRDS in premature infants.

Lung Ultrasound Score Progress in Neonatal Respiratory Distress Syndrome

PEDIATRICS ◽  
2021 ◽  
pp. e2020030528
Author(s):  
Francesco Raimondi ◽  
Fiorella Migliaro ◽  
Iuri Corsini ◽  
Fabio Meneghin ◽  
Pasquale Dolce ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Neonatal Respiratory Distress Syndrome ◽  
Neonatal Respiratory Distress ◽  
Ultrasound Score

scholarly journals Lung ultrasound in diagnosing neonatal respiratory distress syndrome: a meta-analysis

2019 ◽  
Vol 59 (6) ◽  
pp. 340-8
Author(s):  
Hanum Ferdian ◽  
Dian Ibnu Wahid ◽  
Samad Samad ◽  
Anggun Esti Wardani ◽  
Guntur Surya Alam ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Sensitivity And Specificity ◽  
Diagnostic Tool ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Neonatal Respiratory Distress Syndrome ◽  
Inclusion Criteria ◽  
Neonatal Respiratory Distress

Background Neonatal respiratory distress syndrome (NRDS) is commonly diagnosed by clinical sign and symptoms, blood gas analysis, and chest x-ray. In the past, lung ultrasound (LUS) was not standard for NRDS examination. Many studies show that ultrasound diagnostic tool for NRDS is accurate, reliable, low cost, easy to use, and safe because due to no ionizing radiation. Objective To determine the sensitivity and specificity of LUS in diagnosing NRDS. Methods This meta-analysis study was conducted LUS as a diagnostic tool for NRDS. Inclusion criteria were all studies from PubMed, Embase, and The Cochrane Library, without any limitation on published journals, as well as using keywords or search terms of ultrasound, neonatal, and respiratory distress syndrome. Statistical analysis was undertaken using MedCalc® version 18.2 software. Results Seven studies with a total of 580 patients met the inclusion criteria. Proportional meta-analysis obtained random effects models, with total sensitivity of LUS was 97.2% (95% CI for I2 74.24 to 92.88; P<0.0001) and specificity of LUS was 94.8% (95% CI for I2 88.60 to 98.03; P<0.00001). Conclusion Lung ultrasound should be considered as a diagnostic tool for NRDS because it is high in sensitivity and specificity, inexpensive, safe, as well as limited radiation exposure.

scholarly journals Prophylactic Administration of Surfactant in Extremely Premature Infants

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Lutz Koch ◽  
David Frommhold ◽  
Bernd Beedgen ◽  
Peter Ruef ◽  
Johannes Poeschl
Keyword(s):  
Mechanical Ventilation ◽  
Side Effects ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Prophylactic Therapy ◽  
Short Term ◽  
Selective Treatment ◽  
Surfactant Administration

Objective. To investigate whether prophylactic surfactant administration is superior over selective treatment in preterm infants with respiratory distress syndrome (RDS).Methods. In our retrospective analysis, we compared premature infants (23 + 0 to 26 + 6 weeks) receiving 200 mg/kg surfactant (curosurf) within five minutes after birth (prophylactic group, ) with those infants who received surfactant therapy for established RDS (selective group, ).Results. Prophylactic therapy significantly decreased the need for mechanical ventilation (74 hours per patient versus 171 hours per patient, resp.). We observed a reduced incidence of interstitial emphysema (0% versus 9%, resp.), pneumothoraces (3% versus 9%, resp.), chronic lung disease (26% versus 38%, resp.), and surfactant doses per patient (1.3 versus 1.8, resp.), although those variables did not reach significance.Conclusion. We conclude that infants under 27 weeks' gestation profit from prophylactic surfactant administration by reducing the time of mechanical ventilation. This in turn could contribute to reduce the risk for mechanical ventilation associated complications, without any detrimental short-term side effects.

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