Early Lung Ultrasound Scores in Neonates with Respiratory Distress

The goal of a new study was to estimate lung ultrasound (LUS) scores within six hours of birth in neonates with respiratory distress (RD) and evaluate its predictive ability for RD severity.

In this single-center cross-sectional study conducted at a tertiary hospital in South, neonates admitted with RD––during the study period (February 2023 to May 2023)––who had an LUS performed within 6 hours of birth were included. The LUS scoring divided the lung fields into three regions on each side, with each region receiving a score from 0 to 3 – totaling a maximum score of 18. Exclusions were neonates with congenital heart disease, chest/lung anomalies, chromosomal anomalies, and those without an available LUS operator. ROC curves were used to determine the cut-off LUS scores for predicting RD severity, considering outcomes such as FiO2 >50% within the first three days, need for invasive ventilation on day 3, Silverman-Anderson score >7, surfactant requirement, radiological RDS grades, and death. 

The results revealed higher median LUS scores significantly correlating with greater RD severity – FiO2 >50%, invasive ventilation on day 3, Silverman-Anderson score ≥ 7 in preterms, surfactant requirement, radiological RDS grades, and death. Logistic regression showed that the odds ratio for RD severity significantly increased with each unit increase in LUS score.

Therefore, early LUS scores effectively predict the severity and prognosis of neonatal RD. The findings highlighted the utility of a straightforward 6-field LUS scoring system for assessing RD severity in neonates. Early LUS scores can complement clinical assessments with proper training of healthcare personnel.

Source: Aiswarya R, Palanivelraja T, Anurekha V, et al. Indian Pediatrics. 2024 Jun;61(6):558-63.