Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization
Background: Selecting the correct ventilation strategy is crucial for the survival of preterm infants with dyspnea in NICU. Lung ultrasound score (LUSsc) is a potential predictor for respiratory support patterns in preterm infants. Methods: We prospectively included 857 preterm infants. LUS was perf...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957222002765 |
| _version_ | 1797776209707270144 |
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| author | Lihua Zhang Jinnan Feng Di Jin Zekun Yu Yangming Qu Meiyu Zheng Hui Wu |
| author_facet | Lihua Zhang Jinnan Feng Di Jin Zekun Yu Yangming Qu Meiyu Zheng Hui Wu |
| author_sort | Lihua Zhang |
| collection | DOAJ |
| description | Background: Selecting the correct ventilation strategy is crucial for the survival of preterm infants with dyspnea in NICU. Lung ultrasound score (LUSsc) is a potential predictor for respiratory support patterns in preterm infants. Methods: We prospectively included 857 preterm infants. LUS was performed in the first 2 h after admission, and LUSsc was determined by two specialist sonographers. Participants were divided into two categories according to gestational age (<32+0 weeks and 32+0–36+6 weeks) and randomly divided into a training set and a validation set. There were two main outcomes: invasive and non-invasive respiratory support. In the training set, clinical factors were analyzed to find the best cut-off value of LUSsc, and consistency was verified in the verification set. The choice of invasive respiratory support was based on neonatal mechanical ventilation strategies. Results: Preterm infants with invasive respiratory support had a higher LUSsc, greater use of Pulmonary Surfactant（PS）, and lower Oxygenation Index（OI）、birth weight than those with non-invasive support. In the <32+0 weeks group, the area under the curve (AUC) for the receiver operating characteristic curve plotted with 2-h LUSsc was 0.749 (95% CI: 0.689–0.809), the cut-off point of LUSsc was 8, and the sensitivity and specificity were 74.0% and 68.3%, respectively. In the 32+0–36+6 weeks group, the AUC was 0.863 (95% CI: 0.811–0.911), with a cut-off point of 7. Sensitivity and specificity were 75.3% and 0.836%, respectively. In the validation set, using the actual clinical respiratory support selection results for verification, the validation results showed for the <32+0 weeks group (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 LUSsc showed good reliability in predicting respiratory support mode for preterm infants with dyspnea.Registered at ClinicalTrials.gov (identifier: chiCTR1900023869). |
| first_indexed | 2024-03-12T22:46:40Z |
| format | Article |
| id | doaj.art-f3d9e017c17d43dca2ca52b6de0beabb |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-03-12T22:46:40Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
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| series | Pediatrics and Neonatology |
| spelling | doaj.art-f3d9e017c17d43dca2ca52b6de0beabb2023-07-21T04:59:28ZengElsevierPediatrics and Neonatology1875-95722023-07-01644420427Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalizationLihua Zhang0Jinnan Feng1Di Jin2Zekun Yu3Yangming Qu4Meiyu Zheng5Hui Wu6Department of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, ChinaDepartment of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, ChinaDepartment of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, ChinaDepartment of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, ChinaDepartment of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, ChinaDepartment of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, ChinaCorresponding author.; Department of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun 130021, ChinaBackground: Selecting the correct ventilation strategy is crucial for the survival of preterm infants with dyspnea in NICU. Lung ultrasound score (LUSsc) is a potential predictor for respiratory support patterns in preterm infants. Methods: We prospectively included 857 preterm infants. LUS was performed in the first 2 h after admission, and LUSsc was determined by two specialist sonographers. Participants were divided into two categories according to gestational age (<32+0 weeks and 32+0–36+6 weeks) and randomly divided into a training set and a validation set. There were two main outcomes: invasive and non-invasive respiratory support. In the training set, clinical factors were analyzed to find the best cut-off value of LUSsc, and consistency was verified in the verification set. The choice of invasive respiratory support was based on neonatal mechanical ventilation strategies. Results: Preterm infants with invasive respiratory support had a higher LUSsc, greater use of Pulmonary Surfactant（PS）, and lower Oxygenation Index（OI）、birth weight than those with non-invasive support. In the <32+0 weeks group, the area under the curve (AUC) for the receiver operating characteristic curve plotted with 2-h LUSsc was 0.749 (95% CI: 0.689–0.809), the cut-off point of LUSsc was 8, and the sensitivity and specificity were 74.0% and 68.3%, respectively. In the 32+0–36+6 weeks group, the AUC was 0.863 (95% CI: 0.811–0.911), with a cut-off point of 7. Sensitivity and specificity were 75.3% and 0.836%, respectively. In the validation set, using the actual clinical respiratory support selection results for verification, the validation results showed for the <32+0 weeks group (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 LUSsc showed good reliability in predicting respiratory support mode for preterm infants with dyspnea.Registered at ClinicalTrials.gov (identifier: chiCTR1900023869).http://www.sciencedirect.com/science/article/pii/S1875957222002765dyspnealung ultrasoundlung ultrasound score |
| spellingShingle | Lihua Zhang Jinnan Feng Di Jin Zekun Yu Yangming Qu Meiyu Zheng Hui Wu Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization Pediatrics and Neonatology dyspnea lung ultrasound lung ultrasound score |
| title | Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization |
| title_full | Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization |
| title_fullStr | Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization |
| title_full_unstemmed | Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization |
| title_short | Lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization |
| title_sort | lung ultrasound score as a predictor of ventilator use in preterm infants with dyspnea within 24 h after dhospitalization |
| topic | dyspnea lung ultrasound lung ultrasound score |
| url | http://www.sciencedirect.com/science/article/pii/S1875957222002765 |
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