Prediction of Lung Ultrasound Score for Surfactant Requirement in Neonates Less than 30 Weeks of Gestational Age with Respiratory Distress Syndrome

Tahir Mohiuddin Dar, Pirzada Mohammad Suhaib, Maha Ramzan Wani, Mushtaq Ahmad Bhat

Abstract: The study was conducted to evaluate the efficacy of lung ultrasound in predicting the surfactant need in neonates less <30 weeks of gestation with RDS. Forty preterm neonates with GA <30 weeks were included in the study of which 24(60%) were males and 16(40%) were females. The mean GA was 29?1.3weeks and the mean birth weight was 1300?350grams. Patients were clinically assessed using Downe?s score (DS) and those with DS>4 were put on CPAP. Neonates requiring FIO2 >0.3 and not maintaining saturation of >91% were considered for receiving surfactant. Lung ultrasound was done within 2 hours of life before the decision about surfactant administration was made. The median lung ultrasound score in the subjects was 8 (IQR of 2-16) with mean of 8.65?4.05. A LUS score >7 increased the probability with surfactant treatment with sensitivity of 95.2%, specificity of 100% with positive predictive value of 100% and negative predictive value of 95% with diagnostic accuracy of 97.5%. We concluded that LUS in preterm neonates less than 30 weeks of gestation when done early after birth can predict the need for surfactant replacement therapy and can be used as an adjunct if not alternative to FIO2 and CPAP requirements used previously.

Keywords: neonate, preterm, respiratory distress syndrome, lung ultrasound, lung ultrasound score