The Associations Between Lung Ultrasonography Scores in the First Day of Life and Clinical Outcomes.

Abstract

To investigate the role of lung ultrasonography (LU) in predicting noninvasive ventilation (NIV) failure and the relationship between lung ultrasonography scores (LUS) with clinical outcomes in neonatal respiratory failure (NRF). A prospective, cross-sectional study was conducted in newborns with NRF who needed NIV and were evaluated by LU. The first LUS (LUS1) was calculated at 2-6 hours and the second (LUS2) at 12-24 hours of life. The patients were divided into NIV failure and NIV non-failure groups. The relationship between LUS and clinical outcomes was evaluated. Among 157 neonates, the median (interquartile range) of gestational week and birth weight were 37 weeks (34-39), and 2890 grams (2045-3435), respectively. The reasons for NRF were transient tachypnea of the newborn (n=92, 58.6%), congenital pneumonia (n=58, 36.9%), and respiratory distress syndrome (n=7, 4.5%). The rate of NIV failure was 17.8% (n=28). Both LUS1 and LUS2 were significantly higher in neonates with NIV failure compared to neonates with NIV non-failure (P=.001). A cutoff value of LUS1 ≥ 4 predicted NIV failure with 96% sensitivity and 63% specificity. There were positive correlations between LUS and PEEP values, IMV and total MV days, carbon dioxide values, length of hospital stay, and antibiotic days (ρLUS1 , P=.843, <.001; .474, <.001; .444, <.001; .258, .001; .212, .008; .270, <.001, respectively). Lung ultrasound scores were higher in neonates with NIV failure than with NIV non-failure group, and strongly correlated with end-expiratory pressure values. Lung ultrasound scores were found to be related with some of the clinical outcomes of the NRF, and this suggested that LUS could provide information about the prognosis of NRF.