Forthcoming Issue Vol. 19 no. 1 Diagnostic Utility of Lung Ultrasound in Preterm Neonates with Respiratory Distress at a Tertiary Neonatal Intensive Care Unit in South Africa

Main Article Content

Dr Fefekazi Mpisane-Jama
Prof Alan R Horn
Wisdom Basera

Abstract

Background: Accumulating data suggest the potential for lung ultrasound (LUS) to diagnose pathology in preterm babies, but there are no published data from South Africa.


Objectives: To describe LUS diagnoses, respiratory pathology and outcomes in preterm babies receiving non-invasive respiratory support in a tertiary South African neonatal unit, and to compare LUS with clinical diagnoses and surfactant administration.


Methods: We conducted a prospective, observational study of babies at 27–34 weeks’ gestation, birth weight ≥ 800 grams, receiving non-invasive respiratory support who had LUS at age ≤ 3 hours. Surfactant was administered at  fraction of inspired oxygen (FiO2) 0.35–0.45 and was not influenced by LUS findings.


Results: Fifty one neonates were included, of whom 16% received surfactant, all with respiratory distress syndrome (RDS) as their only clinical diagnosis, compared to multiple diagnoses in the non-surfactant group, including RDS (93%), transient tachypnoea of the newborn (TTN) (16%) and pneumonia (14%). Lung ultrasound indicated less RDS in the non-surfactant group than the surfactant group (42% vs. 88%; p=0.02), and more TTN (61% vs. 13%; p=0.01). The LUS score (LUSS) predicted surfactant administration (Area under the curve 0.8 [95% confidence interval 0.67–0.94]). A LUSS of 7 had the best combined sensitivity (75%) and specificity (72%) but a low positive predictive value (33%). A LUSS of 8 identified 8/43 (19%) additional babies for surfactant who did not need treatment.


Conclusion: Lung ultrasound suggested more diagnoses than clinical assessment, particularly TTN, but did not accurately predict surfactant administration at FiO2 0.35–0.45.

Article Details

How to Cite
Forthcoming Issue Vol. 19 no. 1: Diagnostic Utility of Lung Ultrasound in Preterm Neonates with Respiratory Distress at a Tertiary Neonatal Intensive Care Unit in South Africa. (2024). South African Journal of Child Health. https://doi.org/10.7196/
Section
Research
Author Biography

Prof Alan R Horn, University of Cape Town

Prof Alan Horn is a senior Neonatologist in the division of Neonatology, Groote Schuur Hospital and Department of Paediatrics, University of Cape Town, South Africa.

How to Cite

Forthcoming Issue Vol. 19 no. 1: Diagnostic Utility of Lung Ultrasound in Preterm Neonates with Respiratory Distress at a Tertiary Neonatal Intensive Care Unit in South Africa. (2024). South African Journal of Child Health. https://doi.org/10.7196/

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