Lung ultrasound score predicts patent ductus arteriosus ligation among neonates ≤25 weeks

• Published in: Pediatric pulmonology Vol. 58; no. 9; pp. 2487 - 2494
• Main Authors: Zong, Haifeng, Huang, Yichu, Huang, Zhifeng, Zhao, Jie, Lin, Bingchun, Fu, Yongping, Lin, Yanqing, Yu, Yanliang, Sun, Hongyan, Yang, Chuanzhong
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-09-2023
• Subjects: Congenital diseases; Coronary vessels; extremely preterm infants; ligation; lung ultrasound; Newborn babies; patent ductus arteriosus; Premature babies; score; Ultrasonic imaging; score; patent ductus arteriosus; extremely preterm infants; ligation; lung ultrasound
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.26531

Background
This prospective study aimed to investigate whether lung ultrasound score (LUSs) can predict the patent ductus arteriosus (PDA) ligation.
Methods
Preterm infants ≤25 weeks of gestational age (GA) were enrolled. A lung ultrasound was performed on the 14th day of life. Each lung zone was given a score between 0 and 4. A receiver‐operating characteristic (ROC) curve was constructed to evaluate the ability of the LUSs for predicting ligation.
Results
A total of 81 infants were eligible with a median GA and birth weight (BW) of 25 weeks (24.1–25.2) and 710 g (645–770), respectively. The median time from birth to ligation was 35 days (32–51). Those who underwent ligation had a longer time of mechanical ventilation (34 [26–39] vs. 19 [12–30], p < 0.001), shorter time of noninvasive respiratory support (39 [32–51] vs. 50 [41.5–57], p < 0.01), higher incidence of the bronchopulmonary dysplasia (BPD) (p < 0.01), and severe BPD (p < 0.001). The LUSs had an area under the ROC of 0.96 (95% confidence interval: 0.93–0.99) for the prediction of ligation. A LUSs cutoff of 36 has a sensitivity and specificity of 96% and 86% and positive and negative predictive values of 82% and 98%, respectively.
Conclusions
LUSs at an early stage of life can predict PDA ligation in extremely preterm infants. It would be helpful to reduce morbidity by reducing the duration and magnitude of respiratory support.