Early Assessment of Lung Aeration Using an Ultrasound Score As a Biomarker of Developing Bronchopulmonary Dysplasia: a Prospective Observational Study

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2020 Jul 16

PMID 32665687

Citations 22

Authors

Ignacio Oulego-Erroz

Paula Alonso-Quintela

Sandra Terroba-Seara

Aquilina Jimenez-Gonzalez

Silvia Rodriguez-Blanco

Affiliations

Soon will be listed here.

Abstract

The objective of this study was to assess the predictive value of a lung ultrasound (LUS) score in the development of moderate-severe bronchopulmonary dysplasia (sBPD). This was a prospective observational diagnostic accuracy study in a third-level neonatal intensive care unit. Preterm infants with a gestational age below 32 weeks were included. A LUS score (range 0-24 points) was calculated by assessing aeration semiquantitatively (0-3 points) in eight lung zones on the 7th day of life (DOL) and repeated on the 28th DOL. ROC curves and logistic regression were used for analysis. Forty-two preterm infants were included. The LUS on the 7th DOL had an area under the receiver operating characteristic curve (AUROC) of 0.94 (95% CI: 0.87-1) for the prediction of sBPD (optimal cutoff of ≥8 points: sensitivity 93%, specificity 91%). The LUS score was independently associated with sBPD [OR 2.1 (95% CI: 1.1-3.9), p = 0.022, for each additional point in the score]. Conclusions: Lung aeration as assessed by LUS on the 7th DOL may predict the development of sBPD.

Citing Articles

Point-of-care lung ultrasound for continuous positive airway pressure discontinuation in preterm infants.

Myers F, Dasani R, Tong J, Vallandingham-Lee S, Manipon C, Dahlen A J Perinatol. 2024; 45(1):68-72.

PMID: 39496765 DOI: 10.1038/s41372-024-02157-1.

Proportion of confluent B-Lines predicts respiratory support in term infants shortly after birth.

Lin X, Zhang H, Wang X, Zhang R, Zhang L, You X Respir Res. 2024; 25(1):307.

PMID: 39138486 PMC: 11323528. DOI: 10.1186/s12931-024-02944-6.

Lung ultrasound in early prediction of bronchopulmonary dysplasia in pre-term babies.

Abdelrazek A, Kamel S, Elbakry A, Elmazzahy E J Ultrasound. 2024; 27(3):653-662.

PMID: 38907789 PMC: 11333650. DOI: 10.1007/s40477-024-00913-9.

Lung ultrasound score as a tool to predict severity of bronchopulmonary dysplasia in neonates born ≤25 weeks of gestational age.

Zong H, Huang Z, Fu Y, Chen X, Yu Y, Huang Y J Perinatol. 2023; 44(2):273-279.

PMID: 38087005 DOI: 10.1038/s41372-023-01811-4.

Prognostic Relevance of the Lung Ultrasound Score: A Multioutcome Study in Infants with Respiratory Distress Syndrome.

Szymanski P, Puskarz-Gasowska J, Hozejowski R, Stefanska M, Blaz W, Sadowska-Krawczenko I Am J Perinatol. 2023; 41(S 01):e2862-e2869.

PMID: 37848043 PMC: 11150063. DOI: 10.1055/s-0043-1775975.

References

. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001; 69(3):89-95. DOI: 10.1067/mcp.2001.113989. View

Alonso-Ojembarrena A, Lubian-Lopez S . Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants. Pediatr Pulmonol. 2019; 54(9):1404-1409. DOI: 10.1002/ppul.24410. View

Mojoli F, Bouhemad B, Mongodi S, Lichtenstein D . Lung Ultrasound for Critically Ill Patients. Am J Respir Crit Care Med. 2018; 199(6):701-714. DOI: 10.1164/rccm.201802-0236CI. View

Jobe A, Bancalari E . Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001; 163(7):1723-9. DOI: 10.1164/ajrccm.163.7.2011060. View

Onland W, Cools F, Kroon A, Rademaker K, Merkus M, Dijk P . Effect of Hydrocortisone Therapy Initiated 7 to 14 Days After Birth on Mortality or Bronchopulmonary Dysplasia Among Very Preterm Infants Receiving Mechanical Ventilation: A Randomized Clinical Trial. JAMA. 2019; 321(4):354-363. PMC: 6439762. DOI: 10.1001/jama.2018.21443. View

Chiumello D, Umbrello M, Sferrazza Papa G, Angileri A, Gurgitano M, Formenti P . Global and Regional Diagnostic Accuracy of Lung Ultrasound Compared to CT in Patients With Acute Respiratory Distress Syndrome. Crit Care Med. 2019; 47(11):1599-1606. DOI: 10.1097/CCM.0000000000003971. View

McEvoy C, Aschner J . The Natural History of Bronchopulmonary Dysplasia: The Case for Primary Prevention. Clin Perinatol. 2015; 42(4):911-31. PMC: 4662069. DOI: 10.1016/j.clp.2015.08.014. View

Laughon M, Langer J, Bose C, Smith P, Ambalavanan N, Kennedy K . Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants. Am J Respir Crit Care Med. 2011; 183(12):1715-22. PMC: 3136997. DOI: 10.1164/rccm.201101-0055OC. View

Askie L, Ballard R, Cutter G, Dani C, Elbourne D, Field D . Inhaled nitric oxide in preterm infants: an individual-patient data meta-analysis of randomized trials. Pediatrics. 2011; 128(4):729-39. PMC: 3387905. DOI: 10.1542/peds.2010-2725. View

10.

Alvarez-Fuente M, Moreno L, Mitchell J, Reiss I, Lopez P, Elorza D . Preventing bronchopulmonary dysplasia: new tools for an old challenge. Pediatr Res. 2018; 85(4):432-441. DOI: 10.1038/s41390-018-0228-0. View

11.

Abdelmawla M, Louis D, Narvey M, Elsayed Y . A Lung Ultrasound Severity Score Predicts Chronic Lung Disease in Preterm Infants. Am J Perinatol. 2019; 36(13):1357-1361. DOI: 10.1055/s-0038-1676975. View

12.

Bueno-Campana M, Sainz T, Alba M, Del Rosal T, Mendez-Echevarria A, Echevarria R . Lung ultrasound for prediction of respiratory support in infants with acute bronchiolitis: A cohort study. Pediatr Pulmonol. 2019; 54(6):873-880. DOI: 10.1002/ppul.24287. View

13.

Dunn M, Kaempf J, de Klerk A, de Klerk R, Reilly M, Howard D . Randomized trial comparing 3 approaches to the initial respiratory management of preterm neonates. Pediatrics. 2011; 128(5):e1069-76. DOI: 10.1542/peds.2010-3848. View

14.

Brat R, Yousef N, Klifa R, Reynaud S, Aguilera S, De Luca D . Lung Ultrasonography Score to Evaluate Oxygenation and Surfactant Need in Neonates Treated With Continuous Positive Airway Pressure. JAMA Pediatr. 2015; 169(8):e151797. DOI: 10.1001/jamapediatrics.2015.1797. View

15.

Rivera L, Siddaiah R, Oji-Mmuo C, Silveyra G, Silveyra P . Biomarkers for Bronchopulmonary Dysplasia in the Preterm Infant. Front Pediatr. 2016; 4:33. PMC: 4814627. DOI: 10.3389/fped.2016.00033. View

16.

Forster K, Sass S, Ehrhardt H, Mous D, Rottier R, Oak P . Early Identification of Bronchopulmonary Dysplasia Using Novel Biomarkers by Proteomic Screening. Am J Respir Crit Care Med. 2017; 197(8):1076-1080. DOI: 10.1164/rccm.201706-1218LE. View

17.

Walkup L, Woods J . Newer Imaging Techniques for Bronchopulmonary Dysplasia. Clin Perinatol. 2015; 42(4):871-87. DOI: 10.1016/j.clp.2015.08.012. View

18.

De Martino L, Yousef N, Ben-Ammar R, Raimondi F, Shankar-Aguilera S, De Luca D . Lung Ultrasound Score Predicts Surfactant Need in Extremely Preterm Neonates. Pediatrics. 2018; 142(3). DOI: 10.1542/peds.2018-0463. View

19.

Alvarez-Fuente M, Moreno L, Lopez-Ortego P, Arruza L, Avila-Alvarez A, Muro M . Exploring clinical, echocardiographic and molecular biomarkers to predict bronchopulmonary dysplasia. PLoS One. 2019; 14(3):e0213210. PMC: 6402695. DOI: 10.1371/journal.pone.0213210. View

20.

McEvoy C, Jain L, Schmidt B, Abman S, Bancalari E, Aschner J . Bronchopulmonary dysplasia: NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases. Ann Am Thorac Soc. 2014; 11 Suppl 3:S146-53. PMC: 4112507. DOI: 10.1513/AnnalsATS.201312-424LD. View