medigraphic.com
ISSN 0035-0052 (Print)

2026, Number 1

<< Back Next >>

Rev Mex Pediatr 2026; 93 (1)

Lung ultrasound score as a predictor of surfactant need in premature infants

Pérez-González JA, Martínez-Lemus O

Language: Spanish
References: 28
Page: 6-12
PDF size: 1006.77 Kb.


ABSTRACT

Introduction: lung ultrasound (LU) is a diagnostic tool for various conditions in intensive care units. Objective: to evaluate the accuracy of the LU score in predicting the need for pulmonary surfactant in preterm infants. Material and methods: a retrospective cohort study was conducted at the Iván Portuondo Hospital in Cuba between 2022 and 2024. Preterm infants with respiratory distress within the first two hours of life were included. LU was performed prior to surfactant administration. A previously validated scoring scale was used. The Youden index was used to calculate the LU score cutoff, estimating sensitivity and specificity. Results: sixty-two patients were included, with a median gestational age of 31.3 weeks and a median birth weight of 1,447.6 grams. 67.7% required pulmonary surfactant treatment. The median LU score was 12.1 points. A cutoff score of 8 predicted the need for surfactant with a sensitivity of 97.6% and a specificity of 80.0%; however, the cutoff score changed to 5 points for infants < 32 weeks (sensitivity 100%, specificity 66.7%). Conclusions: the UP score, when quantitatively assessed, has good predictive capacity for the need for pulmonary surfactant treatment in premature infants with respiratory distress. However, further research is needed to establish the cutoff value according to gestational age.


REFERENCES

  1. Popat VY, Mehta A, Shah B, Gohil V, Shah M, Thakkar D et al. Accuracy of lung ultrasound score in predicting the need for surfactant theraphy in preterm neonates (less than 34 weeks). Int J Contemp Pediatr. 2025; 12(5): 789-794. doi: 10.18203/2349-3291.ijcp20251100.

  2. Singh Y, Dauengauer-Kirliene S, Yousef N. Setting the standards: neonatal lung ultrasound in clinical practice. Diagnostics (Basel). 2024; 14(13): 1413. doi: 10.3390/diagnostics14131413.

  3. Fernández-Jonusas S, Cribioli CM, De Gregorio AS, Giudice C, Mariani G, Acosta CM. Principios básicos de ecografía pulmonar en neonatología. Arch Argent Pediatr. 2022; 120(6): e246-e254.

  4. Nosrati M, Akhoundi N, Ahmadzadeh NAH, Siami A, Khoshnoud SM, Rezazadeh E et al. The role of lung ultrasonography scoring in predicting the need for surfactant therapy in neonates, with respiratory distress syndrome. J Diagn Med Sonogr. 2023; 39(4): 348-354. doi: 10.1177/87564793231167856.

  5. Brat R, Yousef N, Klifa R, Reynaud S, Shankar-Aguilera S, De Luca D. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr. 2015; 169(8): e151797. doi: 10.1001/jamapediatrics.2015.1797.

  6. Capasso L, Pacella D, Migliaro F, Salomé S, Grasso F, Corsini I, et al. Can lung ultrasound score accurately predict surfactant replacement? A systematic review and meta-analysis of diagnostic test studies. Pediatr Pulmonol. 2023; 58(5): 1427-1437. doi: 10.1002/ppul.26337.

  7. Gupta D, Priyadarshi M, Chaurasia S, Singh P, Basu S. Lung ultrasound for prediction of surfactant requirement in Indian preterm neonates: a diagnostic accuracy study. Eur J Pediatr. 2014; 183(8): 3599-3606. doi: 10.1007/s00431-024-05626-z.

  8. Colectivo de autores. Neonatología. Diagnóstico y tratamiento. 2da ed. La Habana: Editorial de Ciencias Médicas; 2016. p. 95-125.

  9. Raimondi F, Migliaro F, Sodano A, Ferrara T, Lama S, Vallone G et al. Use of neonatal chest ultrasound to predict non invasive ventilation failure. Pediatrics. 2014; 134(4): e1089-e1094. doi: 10.1542/peds.2013-3924.

  10. Directrices sobre Buenas Prácticas Clínicas en Cuba. Centro para el Control Estatal de los Medicamentos, Equipos y Dispositivos Médicos. Ministerio de Salud Pública de Cuba. 2000 Disponible en: https://www.cecmed.cu/sites/default/files/adjuntos/Reglamentacion/Dir_BPC.pdf

  11. Principios éticos para las investigaciones médicas en seres humanos. Asociación Médica Mundial. Declaración de Helsinki. 2020. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/

  12. Rai S, Tripathia S, Kumar M, Singh SN, Kumar S. Lung ultrasound in the management of preterm (≤ 34 weeks) neonates with respiratory distress syndrome. Pediatr Neonatol. 2025; 66(5): 484-489. doi: 10.1016/j.pedneo.2024.07.014.

  13. Ng EH, Shah V. Guidelines for surfactant replacement therapy in neonates. J Paediatr Child Health. 2021; 26(1): 35-41. doi: 10.1093/pch/pxaa116.

  14. van Kaam AH, Niemarkt HJ, Onland W. Timing of surfactant treatment in respiratory distress syndrome. Semin Fetal Neonatal Med. 2023; 28(6): 101495. doi: 10.1016/j.siny.2023.101495.

  15. Rodríguez-Fanjul J, Jordan I, Balaguer M, Batista-Muñoz A, Ramón M, Bobillo-Pérez S. Early surfactant replacement guided by lung ultrasound in preterm newborn with RDS: the ULTRASURF randomized controlled trial. Eur J Pediatr. 2020; 179(12): 1913-1920. doi: 10.1007/s00431-020-03744.

  16. Loganathan PK, Meau-Petit V, Bhojnagarwala B, Nair V, Holmes J, Occhipinti A et al. Serial lung ultrasound in predicting the need forsurfactant and respiratory course in preterm infants-multicentre observational study (SLURP). Eur J Pediatr. 2025; 184(6): 356. doi: 10.1007/s00431-025-06185-7.

  17. De Luca D, Bonadies L, Alonso-Ojembarrena A, Martino D, Gutierrez-Rosa I, Loi B et al. Quantitative lung ultrasonography to guide surfactant therapy in neonates born late preterm and later. JAMA Netw Open. 2024; 7(5): e2413446. doi: 10.1001/jamanetworkopen.2024.13446.

  18. Li M, Li, M, Feng J, Xiao F, Yang Q. Predictive value of lung ultrasound score in weaning from mechanical ventilation in neonatal respiratory distress syndrome. Ital J Pediatr. 2025; 51(1): 132. doi: 10.1186/s13052-025-01946-4.

  19. Romadhan M, Etika R, Utomo MT, Angelika D, Handayani KD, Ayuningtyas W et al. Lung ultrasonography score as a predictor of RDS severity in premature infants. Acta Biomed. 2025; 96(2): 16456. doi: 10.23750/abm.v96i2.16456.

  20. Singh P, Patnaik S, Verma A, Garegrat R, Maheshwari R, Suryawanshi P. Diagnostic utility of the lung ultrasound in predicting the need for surfactant therapy in preterm neonates with respiratory distress. Front Pediatr. 2023; 11: 1307761. doi: 10.3389/fped.2023.1307761.

  21. Corsini I, Lenzi MB, Ciarciá M, Matina F, Petoello E, Flore AI. Comparison among three lung ultrasound scores used to predict the need for surfactant replacement therapy: a retrospective diagnostic accuracy study in a cohort of preterm infants. Eur J Pediatr. 2023; 182(12): 5375-5383. doi: 10.1007/s00431-023-05200-z.

  22. De Martino L, Yousef N, Ben Ammar R, Raimondi F, Shankar-Aguilera S, De Luca D. Lung ultrasound score predicts surfactant need in extremely preterm neonates. Pediatrics. 2018; 142(3): e20180463. doi: 10.1542/peds.2018-0463.

  23. Román-Fernández A, Gómez-Ávila J. Biparametric score as a new tool for early indication of surfactant in preterm infants. J Pediatr (Rio J). 2025; 101(5): 101425. doi: 10.1016/j.jped.2025.101425.

  24. Gregorio-Hernández R, Arriaga-Redondo M, Pérez-Pérez A, Ramos-Navarro C, Sánchez-Luna M. Lung ultrasound in preterm infants with respiratory distress: experience in a neonatal intensive care unit. Eur J Pediatr. 2020; 179(1): 81-89. doi: 10.1007/s00431-019-03470-0.

  25. Kelner J, Moote D, Shah R, Anuar A, Golioto A. Lung ultrasound score for prediction of surfactant administration in preterm infants with respiratory failure. J Perinatol. 2024; 44(9): 1258-1263. doi: 10.1038/s41372-024-02090-3.

  26. Razak A, Faden M. Neonatal lung ultrasonography to evaluate need for surfactant or mechanical ventilation. Arch Dis Child Fetal Neonatal Ed. 2019; 105(2): 164-171. doi: 10.1136/archdischild2019-316832.

  27. Aldecoa-Bilbao V, Balcells-Esponera C, Barbero AH, Borrás-Novel C, Renau MI, Iriondo-Sanz M et al. Lung ultrasound for early surfactant treatment: development and validation of a predictive model. Pediatr Pulmonol. 2021; 56(2): 433-441. doi: 10.1002/ppul.25216.

  28. Raimondi F, Dolce P, Veropalumbo C, Sierchio E, Gregorio-Hernandez R, Rodríguez-Fanjul J et al. External validation of a multivariate model for targeted surfactant replacement. Neonatology. 2024; 121(1): 17-24. doi: 10.1159/000532083.




2020     |     www.medigraphic.com