NICU Fellow Baylor Scott White McLane Children's Medical Center Temple, Texas, United States
Background: Point-of-care lung ultrasounds (LUS) have been reported to have high accuracy measures in the diagnosis of neonatal lung pathologies including respiratory distress syndrome (RDS), transient tachypnea of tachypnea, and noted to have high predictive values for the need for surfactant in RDS and development of bronchopulmonary dysplasia (BPD). Postnatal systemic steroids (Dexamethasone, DART) are used in preterm infants to facilitate extubation and to decrease the risk of BPD. LUS may have a role in identifying infants who would benefit most from systemic steroids and predicting the probability of successful extubation following course of systemic steroid course. Objective: To describe and evaluate changes in LUS scores pre and post-treatment with systemic steroid course. Design/Methods: A multicenter prospective study. Each LUS procedure involves obtaining six LUS images (4 views of the anterior chest wall; upper and lower on the left and right sides and 2 lateral views on the right and left sides) on the day before the administration of steroids (Day 0), followed by days 1,3, 7 & 10 over the 10-day course of DART and 1-week post completion of steroids (Day 17). LUS scores are calculated from each procedure, ranging from 0 to 18 by investigators and blinded reviewers. The trajectory of LUS scores for steroids is described and a comparison of LUS scores before and after a course of post-natal steroids is analyzed using a signed Wilcoxon rank sum test. Additionally, LUS scores are compared between infants who were successfully weaned of respiratory support and those who were unsuccessful.
