Point-of-care lung ultrasound for continuous positive airway pressure discontinuation in preterm infants.

Autor: Myers F; Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA. faith.myers@childrensMN.org., Dasani R; Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA., Tong J; Lucile Packard Children's Hospital at Stanford University, Palo Alto, CA, USA., Vallandingham-Lee S; Lucile Packard Children's Hospital at Stanford University, Palo Alto, CA, USA., Manipon C; Lucile Packard Children's Hospital at Stanford University, Palo Alto, CA, USA., Dahlen A; Biostatistical Collaboration and Consultation Core, Department of Biostatistics, School of Global Public Health at New York University, New York, NY, USA., De Luca D; Division of Pediatrics and Neonatal Critical Care, South Paris University Hospitals, Medical Center 'A. Beclere, ' Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.; Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France., Singh Y; Department of Pediatrics, Division of Neonatology, UC Davis Children's Hospital, Sacramento, CA, USA., Davis AS; Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA., Chock VY; Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA., Bhombal S; Division of Neonatology, Emory University/Children's Healthcare of Atlanta, Atlanta, GA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Nov 04. Date of Electronic Publication: 2024 Nov 04.
DOI: 10.1038/s41372-024-02157-1
Abstrakt: Objective: To determine if the lung ultrasound score (LUS) is predictive of successful continuous positive airway pressure (CPAP) discontinuation in preterm neonates born <32 weeks' gestation with history of respiratory distress syndrome.
Study Design: Retrospective study of preterm infants requiring CPAP. Univariate and multivariate logistic regression performed to formulate a predictive score using clinical variables with and without LUS. Area under the curve (AUC) was compared to determine the added predictive ability of LUS.
Results: Forty-one patients with discontinuation attempts associated with a LUS were included. Lower LUS obtained within 0-7 days prior to CPAP discontinuation was associated with successful CPAP discontinuation (OR 0.46 [0.23, 0.91]; p = 0.025). Cross-validated AUC for clinical variables alone (Model 1) was 0.85 (95% CI: 0.74-0.93) versus 0.90 (95% CI: 0.81-0.97) when LUS was incorporated (Model 2, p < 0.001). AUC of LUS alone was 0.83 (95% CI: 0.68-0.93, p < 0.0001).
Conclusions: In preterm infants requiring CPAP, LUS aids in the prediction of successful CPAP discontinuation and may significantly improve a predictive tool.
(© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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