Nirmal Kumar Gautam, Venkatesh H A, Rajath Pejaver, Karthik Nagesh
{"title":"床边“护理点肺超声”在预测晚期早产儿和足月新生儿在出生后不久出现呼吸窘迫的过渡期是否需要入住新生儿重症监护病房中的诊断应用：一项前瞻性观察研究。","authors":"Nirmal Kumar Gautam, Venkatesh H A, Rajath Pejaver, Karthik Nagesh","doi":"10.1002/ppul.71000","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Point of care lung ultrasound (POC-LUS) is a rapid and simple method to evaluate infants with respiratory distress after birth.</p><p><strong>Objectives: </strong>The primary objective was to determine whether the POC-LUS score is a good predictor of NICU admission in late preterm and term infants born with respiratory distress when performed within the first 2 h of life. The secondary objective was to find a correlation between the LUS score and the clinical respiratory distress severity score.</p><p><strong>Methods: </strong>A prospective observational study was carried out in a tertiary care neonatal unit (Level III) over 1 year on 97 late preterm and term infants having respiratory distress at birth. POC-LUS was performed in a transition nursery area within 2 h of birth, and LUS score was recorded as per a pre-validated LUS scoring system. The decision for NICU admission was independently taken by the medical team based on clinical criteria and blinded to the LUS findings. A receiver operating characteristic (ROC) curve was generated to predict NICU admission based on the LUS score. LUS score was also analyzed for correlation with clinical respiratory distress severity scoring, that is, Silverman-Anderson score (SA score).</p><p><strong>Results: </strong>The mean gestational age of the infants in the study was 37.45 ± 1.88 weeks. Fourty-three percent of infants needed NICU admission. LUS score > 5/18 performed within 2 h after birth was an excellent predictor of NICU admission in late preterm and term infants with respiratory distress after birth (area under ROC curve 0.903, sensitivity 64%, specificity 98%, positive likelihood ratio 35, and p < 0.001). LUS score also had a weak positive correlation with the SA score (Pearson's correlation, r = 0.325; p = 0.001).</p><p><strong>Conclusion: </strong>A LUS score of > 5/18 is an excellent predictor of NICU admission in term and late-preterm infants with respiratory distress after birth.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 2","pages":"e71000"},"PeriodicalIF":2.3000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic Utility of Bedside \\\"Point of Care Lung Ultrasound\\\" in Predicting the Need For NICU Admission in Late Preterm and Term Newborns Having Respiratory Distress Soon After Birth in the Transition Period: A Prospective Observational Study.\",\"authors\":\"Nirmal Kumar Gautam, Venkatesh H A, Rajath Pejaver, Karthik Nagesh\",\"doi\":\"10.1002/ppul.71000\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Point of care lung ultrasound (POC-LUS) is a rapid and simple method to evaluate infants with respiratory distress after birth.</p><p><strong>Objectives: </strong>The primary objective was to determine whether the POC-LUS score is a good predictor of NICU admission in late preterm and term infants born with respiratory distress when performed within the first 2 h of life. The secondary objective was to find a correlation between the LUS score and the clinical respiratory distress severity score.</p><p><strong>Methods: </strong>A prospective observational study was carried out in a tertiary care neonatal unit (Level III) over 1 year on 97 late preterm and term infants having respiratory distress at birth. POC-LUS was performed in a transition nursery area within 2 h of birth, and LUS score was recorded as per a pre-validated LUS scoring system. The decision for NICU admission was independently taken by the medical team based on clinical criteria and blinded to the LUS findings. A receiver operating characteristic (ROC) curve was generated to predict NICU admission based on the LUS score. LUS score was also analyzed for correlation with clinical respiratory distress severity scoring, that is, Silverman-Anderson score (SA score).</p><p><strong>Results: </strong>The mean gestational age of the infants in the study was 37.45 ± 1.88 weeks. Fourty-three percent of infants needed NICU admission. LUS score > 5/18 performed within 2 h after birth was an excellent predictor of NICU admission in late preterm and term infants with respiratory distress after birth (area under ROC curve 0.903, sensitivity 64%, specificity 98%, positive likelihood ratio 35, and p < 0.001). LUS score also had a weak positive correlation with the SA score (Pearson's correlation, r = 0.325; p = 0.001).</p><p><strong>Conclusion: </strong>A LUS score of > 5/18 is an excellent predictor of NICU admission in term and late-preterm infants with respiratory distress after birth.</p>\",\"PeriodicalId\":19932,\"journal\":{\"name\":\"Pediatric Pulmonology\",\"volume\":\"60 2\",\"pages\":\"e71000\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Pulmonology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ppul.71000\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Pulmonology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ppul.71000","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Diagnostic Utility of Bedside "Point of Care Lung Ultrasound" in Predicting the Need For NICU Admission in Late Preterm and Term Newborns Having Respiratory Distress Soon After Birth in the Transition Period: A Prospective Observational Study.
Background: Point of care lung ultrasound (POC-LUS) is a rapid and simple method to evaluate infants with respiratory distress after birth.
Objectives: The primary objective was to determine whether the POC-LUS score is a good predictor of NICU admission in late preterm and term infants born with respiratory distress when performed within the first 2 h of life. The secondary objective was to find a correlation between the LUS score and the clinical respiratory distress severity score.
Methods: A prospective observational study was carried out in a tertiary care neonatal unit (Level III) over 1 year on 97 late preterm and term infants having respiratory distress at birth. POC-LUS was performed in a transition nursery area within 2 h of birth, and LUS score was recorded as per a pre-validated LUS scoring system. The decision for NICU admission was independently taken by the medical team based on clinical criteria and blinded to the LUS findings. A receiver operating characteristic (ROC) curve was generated to predict NICU admission based on the LUS score. LUS score was also analyzed for correlation with clinical respiratory distress severity scoring, that is, Silverman-Anderson score (SA score).
Results: The mean gestational age of the infants in the study was 37.45 ± 1.88 weeks. Fourty-three percent of infants needed NICU admission. LUS score > 5/18 performed within 2 h after birth was an excellent predictor of NICU admission in late preterm and term infants with respiratory distress after birth (area under ROC curve 0.903, sensitivity 64%, specificity 98%, positive likelihood ratio 35, and p < 0.001). LUS score also had a weak positive correlation with the SA score (Pearson's correlation, r = 0.325; p = 0.001).
Conclusion: A LUS score of > 5/18 is an excellent predictor of NICU admission in term and late-preterm infants with respiratory distress after birth.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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