Use of Lung Ultrasound and Thoracic Fluid Content for Prediction of non-Invasive Ventilation Failure in Neonates
Keywords:
Lung Ultrasound, Thoracic Fluid Content, Non-Invasive Ventilation Failure, NeonatesAbstract
Purpose: Non-invasive ventilation (NIV) is commonly employed as the primary respiratory support modality in neonates with respiratory distress due to its lower risk of complications compared to invasive mechanical ventilation. This research aimed to compared between lung ultrasound and thoracic fluid content (TFC) as early predictive tools for identifying NIV failure in premature neonates.
Methods: This prospective cohort observational research involved 60 preterm neonates aged from 28 to 35 weeks old, both sexes, suffered from respiratory distress syndrome which were candidate to NIV. Patients were categorized into two equal groups: Group I: Nasal CPAP (continuous positive airway pressure) and gestational age (GA) 28-35 W and group II: nasal intermittent mandatory ventilation and GA 28-35 W.
Results: Lung ultrasound score (LUS) strongly associated with TFC in the case of NIV failure. The LUS score demonstrated a marked increase in the group that experienced failure opposed to the group that succeeded. Additionally, TFC measured via EC in NIPPV was significantly elevated in the failure group opposed to the success group.
Conclusions: LUS score correlates well with TFC, in the case of NIV failure and it may serve as a valuable tool for tracking changes in lung aeration during the early application of NIV in premature infants.
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References
Ramaswamy VV, Devi R, Kumar G. Non-invasive ventilation in neonates: a review of current literature. Front Pediatr. 2023;11:1248836.
Im JE, Park S, Kim YJ, Yoon SA, Lee JH. Predicting the need for intubation within 3 h in the neonatal intensive care unit using a multimodal deep neural network. Sci Rep. 2023;13:6213.
Perez J, Brandan L, Telias I. Monitoring patients with acute respiratory failure during non-invasive respiratory support to minimize harm and identify treatment failure. Crit Care. 2025;29:147.
Reuter S, Moser C, Baack M. Respiratory distress in the newborn. Pediatr Rev. 2014;35:417-28; quiz 29.
El-Masry H, Aladawy MA, Mansor TM, Abo El Magd HA. Comparative study between chest X-ray and lung ultrasound in neonatal respiratory distress. Annals of Neonatology Journal. 2021;3:125-43.
Miller LE, Stoller JZ, Fraga MV. Point-of-care ultrasound in the neonatal ICU. Curr Opin Pediatr. 2020;32:216-27.
Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, et al. European consensus guidelines on the management of respiratory distress syndrome - 2016 update. Neonatol. 2017;111:107-25.
Raimondi F, Migliaro F, Sodano A, Ferrara T, Lama S, Vallone G, et al. Use of neonatal chest ultrasound to predict noninvasive ventilation failure. Pediatrics. 2014;134:1089-94.
Sumbel L, Wats A, Salameh M, Appachi E, Bhalala U. Thoracic Fluid Content (TFC) Measurement Using Impedance Cardiography Predicts Outcomes in Critically Ill Children. Front Pediatr. 2020;8:564902.
Salvo V, Lista G, Lupo E, Ricotti A, Zimmermann LJI, Gavilanes AWD, et al. Comparison of three non-invasive ventilation strategies (NSIPPV/BiPAP/NCPAP) for RDS in VLBW infants. J Matern Fetal Neonatal Med. 2018;31:2832-8.
Perri A, Sbordone A, Patti ML, Nobile S, Tirone C, Giordano L, et al. Early lung ultrasound score to predict noninvasive ventilation needing in neonates from 33 weeks of gestational age: A multicentric study. Pediatr Pulmonol. 2022;57:2227-36.
Noori S, Drabu B, Soleymani S, Seri I. Continuous non-invasive cardiac output measurements in the neonate by electrical velocimetry: a comparison with echocardiography. Arch Dis Child Fetal Neonatal Ed. 2012;97:F340-3.
Lemyre B, Davis PG, De Paoli AG, Group CN. Nasal intermittent positive pressure ventilation (NIPPV) versus nasal continuous positive airway pressure (NCPAP) for apnea of prematurity. CDSR. 1996;2010:132-46.
Michard F. Lung water assessment: from gravimetry to wearables. J Clin Monit Comput. 2019;33:1-4.
Hammad Y, Hasanin A, Elsakka A, Refaie A, Abdelfattah D, Rahman SA, et al. Thoracic fluid content: a novel parameter for detection of pulmonary edema in parturients with preeclampsia. J Clin Monit Comput. 2019;33:413-8.
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