Lung Ultrasound Score for Prediction of Surfactant Administration in Preterm Infants with Respiratory Failure

Abstract

OBJECTIVE: We investigated the predictive value of a lung ultrasound score (LUS) for surfactant administration in a United States Level 4 Neonatal Intensive Care Unit. STUDY DESIGN: 30 infants born at <37 weeks gestational age with respiratory distress syndrome associated respiratory failure requiring continuous positive airway pressure were included. A LUS was obtained within six hours of life. Surfactant administration in the first five days of life was tracked. Receiver operating characteristic analysis for LUS and surfactant administration was performed. RESULTS: Median completed gestational age was 32 weeks (31-34w) and median birth weight was 2.0 kg (1.5-2.3kg). LUS for predicting an initial surfactant dose had an area under the receiver operating characteristic curve of 0.97. A score of >9 provided 100% sensitivity and 91% specificity for predicting administration of an initial surfactant dose. CONCLUSION: A LUS >9 provided excellent sensitivity and specificity for predicting which infants received surfactant.