AI Article Synopsis
- A study was done to see how well lung ultrasound (LUS) can predict if preterm babies under 32 weeks will need to be put back on a breathing machine after being taken off.
- The results showed that LUS wasn't very good at predicting this for most babies, but it worked better for extremely preterm babies (born before 28 weeks) and those who were very young (under 72 hours old).
- Researchers think they should study babies who are at high risk of needing to go back on the machine and maybe use simpler ways to check their lungs in the future.
Article Abstract
Objective: To determine the accuracy of pre-extubation lung ultrasound (LUS) to predict reintubation in preterm infants born <32 weeks' gestation.
Design: Prospective diagnostic accuracy study.
Setting: Two neonatal intensive care units.
Methods: Anterior and lateral LUS was performed pre-extubation. The primary outcome was the accuracy of LUS scores (range 0-24) to predict reintubation within 72 hours. Secondary outcomes were accuracy in predicting (1) reintubation within 7 days, (2) reintubation stratified by postnatal age and (3) accuracy of lateral imaging only (range 0-12). Pre-specified subgroup analyses were performed in extremely preterm infants born <28 weeks' gestation. Cut-off scores, sensitivities and specificities were calculated using receiver operating characteristic analysis and reported as area under the curves (AUCs).
Results: One hundred preterm infants with a mean (SD) gestational age of 27.4 (2.2) weeks and birth weight of 1059 (354) g were studied. Thirteen were subsequently reintubated. The AUC (95% CI) of the pre-extubation LUS score for predicting reintubation was 0.63 (0.45-0.80). Accuracy was greater in extremely preterm infants: AUC 0.70 (0.52-0.87) and excellent in infants who were <72 hours of age at the time of extubation: AUC 0.90 (0.77-1.00). Accuracy was poor in infants who were >7 days of age. Lateral imaging alone demonstrated similar accuracy to scanning anterior and lateral regions.
Conclusions: In contrast to previous studies, LUS was not a strong predictor of reintubation in preterm infants. Accuracy is increased in extremely preterm infants. Future research should focus on infants at highest risk of extubation failure and consider simpler imaging protocols.
Trial Registration Number: Australian New Zealand Clinical Trials Registry: ACTRN12621001356853.
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| http://dx.doi.org/10.1136/archdischild-2024-327172 | DOI Listing |
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