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Lung ultrasound outperformed chest X-ray in predicting intubation
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Lung ultrasound was a useful predictor of neonatal need for intubation and significantly outperformed chest X-ray, according to study findings in Pediatrics.
Francesco Raimondi, MD, PhD, of the University of Naples Federico II in Naples, Italy, and colleagues assessed the accuracy of lung ultrasound and chest X-ray in predicting intubation within 24 hours of scanning among newborns. Infants in the study (n=54) were admitted to the neonatal ICU with moderate respiratory distress and stabilized on nasal continuous positive airway pressure for 120 minutes. Patients had a gestational age of 32.5 ± 2.6 weeks.
Bilateral type 1 lung ultrasound had a sensitivity of 88.9%, a specificity of 100%, a positive predicative value of 100% and a negative predicative value of 94.7% in predicting failure of noninvasive ventilation.
Grade 2 chest X-ray had a sensitivity of 38.9%, a specificity of 77.8%, a positive predicative value of 46.7% and a negative predicative value of 71.8% in predicting intubation, according to the study findings.
There was full interobserver agreement in the images’ interpretation.
The average duration of a complete ultrasound scan was 2.5 minutes and was well-tolerated by study participants.
“Although noninvasive ventilation is an effective and gentle way of respiratory support in the preterm infant, it is not without limits or risks. At the bedside, lung ultrasonography is an accurate method for predicting the failure of noninvasive ventilation and it is advantageous over chest radiography,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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