Erschienen in:
14.06.2022 | Original Article
Semi-quantitative lung ultrasound score during ground transportation of outborn neonates with respiratory failure
verfasst von:
Vincent Ollier, Barbara Loi, Clemence Rivaud, Feriel Fortas, Valerie Ruetsch, Nadya Yousef, Gilles Jourdain, Daniele De Luca
Erschienen in:
European Journal of Pediatrics
|
Ausgabe 8/2022
Einloggen, um Zugang zu erhalten
Abstract
Lung ultrasound score (LUS) is increasingly diffused in neonatal critical care but scanty data are available about its use during transfer of severely ill neonates. We aimed to clarify the effect of ground transportation on LUS evolution, conformity of interpretation, and relationships with oxygenation and clinical severity. This is a single-center, blinded, observational, cross-sectional study. Neonates of any gestational age with respiratory distress appearing within 24 h from birth were transferred by a mobile unit towards neonatal intensive care unit (NICU) of a tertiary referral center. Calculation of LUS prior to the transportation (T1), in the mobile unit (T2), at the end of transportation (T3), and finally upon NICU admission. LUS in the mobile unit and in the NICU was performed by different physicians blinded to each other’s results. LUS did not change overtime (T1: 6.3 (3.5), T2: 6.1 (3.5), T3: 5.8 (3.4); p = 0.479; adjusted for gestational or postnatal age or transport duration: p = 0.951, p = 0.424, and 0.266, respectively) but reliably predicted surfactant need (AUC at T1: 0.833 (95%CI: 0.72–0.92); AUC at T2: 0.82 (95%CI: 0.70–0.91); AUC at T3: 0.82 (95%CI: 0.70–0.90); p always < 0.0001). There were significant agreement (ICC = 0.912 (95%CI: 0.83–0.95); p < 0.001) and correlation (r = 0.905, p < 0.001) between LUS calculated during transportation and in the NICU. LUS during transportation was also significantly correlated with oxygenation index (r = 0.321, p = 0.026; standardized B = 0.397 (95%CI: 0.03–0.76), p = 0.048) and TRIPS-II score (r = 0.302, p = 0.008; standardized B = 0.568 (95%CI: 0.04–1.1), p = 0.037).
Conclusion: LUS during ground transportation of neonates with respiratory failure is suitable and not influenced by the transportation itself. It has a high agreement with that calculated in the NICU and correlates with patients’ oxygenation and severity.
What is Known: • Lung ultrasound is a part of the point-of-care
ultrasound, which is becoming an essential tool, to manage critically ill
neonates and children in an accurate, non-invasive and quick way. |
What is New: • Lung ultrasound score (LUS) is suitable during
transportation of critically ill neonates with respiratory failure and is not
influenced by the transportation itself.
• LUS has a high agreement with that calculated in the
NICU and correlates with patients’ oxygenation and severity of respiratory
failure. |