Lung ultrasound during newborn resuscitation predicts the need for surfactant therapy in very- and extremely preterm infants

IntroductionEarly identification of infants requiring surfactant therapy improves outcomes. We evaluated the accuracy delivery room lung ultrasound (LUS) to predict in very- and extremely preterm infants.MethodsInfants born at <320/7 weeks were prospectively enrolled 2 centres. LUS videos both sides chest obtained 5?10 min, 11?20 1?3 h after birth. Clinicians masked results assessment was provided according local guidelines. graded blinded clinical data. Presence unilateral type 1 (‘whiteout’) or worse considered test positive. Receiver Operating Characteristic (ROC) analysis compared an FiO2 threshold 0.3 subsequent therapy.ResultsFifty-two with a median age 276/7 (IQR 260/7–286/7) studied. Thirty (58%) received surfactant. Area under ROC curve (AUC) for 5–10 11–20 min 0.78 (95% CI, 0.66–0.90), 0.76 0.65–0.88) 0.86 0.75–0.97) respectively, outperforming timepoint (AUC 0.45, 95% CI 0.29–0.62, p = 0.001). At had specificity 77–100%) sensitivity 59% 39–77%) therapy. All 23–276/7 positive Twenty-six (50%) worsening grades on serial assessment.ConclusionsLUS accurately predicts weeks.