The clinical value of lung ultrasound scores predicting pulmonary surfactant use in premature infants with respiratory distress syndrome
10.3760/cma.j.issn.2096-2932.2023.11.006
- VernacularTitle:肺部超声评分预测呼吸窘迫综合征早产儿应用肺表面活性物质的研究
- Author:
Lihua ZHANG
1
;
Chunying NIU
;
Jinnan FENG
;
Shuaiwen DING
;
Hui WU
Author Information
1. 吉林大学第一医院新生儿科，长春 130012
- Keywords:
Preterm infant;
Lung ultrasound score;
Respiratory distress syndrome;
Pulmonary surfactant
- From:Chinese Journal of Neonatology
2023;38(11):665-670
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical value of lung ultrasound score (LUSsc) within 2 h after birth for pulmonary surfactant (PS) use in preterm infants with respiratory distress syndrome (RDS).Methods:From July 2019 to May 2021, preterm infants with RDS hospitalized in our hospital and received pulmonary ultrasound within 2 h after birth were prospectively enrolled. 12-area LUSsc was calculated. The infants were assigned into <32 weeks group and 32-36 weeks group according to gestational age (GA). Simple random sampling was carried out in each group with 1/5 as the validation set and the other 4/5 as the training set. The infants were also assigned into PS group and non-PS group according to PS usage within 24 h after birth. Receiver operator characteristic (ROC) curve of LUSsc predicting PS usage was drawn and validated.Results:A total of 857 RDS infants were enrolled, including 313 in <32 weeks group and 544 in 32-36 weeks group. For <32 weeks group, area under curve (AUC) of LUSsc>8.5 predicting PS use was 0.779 (95% CI 0.722-0.837), with 76.4% sensitivity and 81.4% specificity. The accuracy of using LUSsc>8.5 as cut-off predicting actual clinical PS application was 82.3% (Kappa value 0.692, P<0.05, McNemar's test P>0.05).For 32-36 weeks group, AUC of LUSsc>9.5 predicting PS use was 0.785 (95% CI 0.723-0.848), with 71.1% sensitivity and 81.7% specificity. The accuracy of using LUSsc>9.5 as cut-off predicting actual clinical PS application was 92.6% (Kappa value 0.772, P<0.05, McNemar's test P>0.05). Conclusions:LUSsc within 2 h after birth is independent predictor of PS use in preterm infants with RDS. For <32 weeks group, LUSsc>8.5 suggests PS application and for 32-36 weeks group the cut-off is LUSsc>9.5.
