Prediction of extubation readiness using lung ultrasound in preterm infants
Reem M. Soliman MD
Department of Pediatrics, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorYasser Elsayed MD
Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
Search for more papers by this authorReem N. Said MD
Department of Pediatrics, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorAbdulaziz M. Abdulbaqi MD
Department of Pediatrics, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorRania H. Hashem MD
Department of Radiology, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorCorresponding Author
Hany Aly MD
Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
Correspondence Hany Aly, MD, MSHS, 9500 Euclid Ave, M31-37, Cleveland, OH 44195, USA.
Email: [email protected]
Search for more papers by this authorReem M. Soliman MD
Department of Pediatrics, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorYasser Elsayed MD
Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
Search for more papers by this authorReem N. Said MD
Department of Pediatrics, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorAbdulaziz M. Abdulbaqi MD
Department of Pediatrics, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorRania H. Hashem MD
Department of Radiology, Cairo University Children's Hospital, Cairo, Egypt
Search for more papers by this authorCorresponding Author
Hany Aly MD
Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
Correspondence Hany Aly, MD, MSHS, 9500 Euclid Ave, M31-37, Cleveland, OH 44195, USA.
Email: [email protected]
Search for more papers by this authorAbstract
We aimed to test the hypothesis that a lung ultrasound severity score (LUS) and assessment of left ventricular eccentricity index of the interventricular septum (LVEI) by focused heart ultrasound can predict extubation success in mechanically ventilated infants. We conducted a prospective study on premature infants less than 34 weeks’ of gestation. LUS was performed on postnatal Days 3 and 7 by an investigator who was masked to infants’ ventilator parameters. LVEI and pulmonary artery pressure (PAP) were measured at postnatal Day 3. A receiver operator curve was constructed to assess the ability to predict extubation success. Spearman correlation was performed between LVEI and PAP. A total of 104 studies were performed to 66 infants; of them 39 had mild and 65 had moderate-severe lung disease. LUS predicted extubation success with a sensitivity and a specificity of 91% and 69%, respectively. Area under the curve was 0.83 (CI: 0.75–0.91). LVEI did not differ between infants that succeeded and failed extubation. It correlated with PAP during systole (r = .66). We conclude that LUS predicts extubation success in mechanically ventilated preterm infants whereas LVEI correlates with high PAP.
CONFLICT OF INTERESTS
All authors declare no financial or conflict of interest in relation to this Funding: There is no funding source.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
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| ppul25383-sup-0001-Fig_S1.tiff228.8 KB | Supporting information. |
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| ppul25383-sup-0005-Supplemental_Table_S1.docx19.2 KB | Supporting information. |
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