Lung ultrasound serves as an important guide to treatment in critically ill patients with acute respiratory failure. Due to its characteristics, it could also prove helpful in extremely preterm infants with evolving chronic respiratory failure, as there is a lack of accurate imaging tools to monitor them.

A group of investigators verified the capability of lung ultrasound to monitor lung aeration and function and its reliability to predict bronchopulmonary dysplasia in extremely preterm neonates.

They carried out a multicenter, international, prospective, longitudinal, cohort, diagnostic accuracy study consecutively enrolling inborn neonates with gestational age 30+6 weeks or younger. The lung ultrasound of the enrolled subjects was performed on the 1, 7, 14, and 28 days of life. Further, the lung ultrasound scores were calculated and correlated with simultaneous blood gases and work of breathing score. Gestational age-adjusted lung ultrasound scores were created and verified in multivariate models. These scores were further subjected to receiver operator characteristics (ROC) analyses to predict bronchopulmonary dysplasia at 36 weeks postmenstrual age.

The researchers found-

• Mean lung ultrasound scores are different between infants developing or not developing bronchopulmonary dysplasia.
• Lung ultrasound scores showed a significant correlation with oxygenation metrics and work of breathing at any time point.
• Gestational age-adjusted lung ultrasound scores showed a significant prediction of bronchopulmonary dysplasia at 7 and 14 days of life.
• A significant correlation was found between Bronchopulmonary dysplasia severity and gestational age-adjusted lung ultrasound scores at 7 and 14 days.

Thus, they concluded that the lung ultrasound scores allow monitoring of lung aeration and function in extremely preterm infants and the gestational age-adjusted scores significantly predict the occurrence of bronchopulmonary dysplasia, from the seventh day of life.

Loi B, Vigo G, Baraldi E, Raimondi F, Carneillli VP, Mosca F, Luca DD. Lung Ultrasound to Monitor Extremely Preterm Infants and Predict Bronchopulmonary Dysplasia. A Multicenter Longitudinal Cohort Study, American Journal of Respiratory and Critical Care Medicine;203(11)