P1.170: Utility of Lung ultrasound score in predicting respiratory outcomes and NICHD BPD outcome estimator in preterm neonates

Background: Lung ultrasound has been used to monitor lung aeration, pulmonary edema, and consolidation. Multiple studies have used Lung ultrasound score (LUS) in predicting presence or absence of Bronchopulmonary dysplasia (BPD). LImited studies have reviewed association with grading of BPD and association with BPD risk estimator. We designed a prospective observational study to assess the utility of LUS in correlating with moderate-severe BPD risk outcome estimator, moderate-severe BPD (Jensen 2019 criteria), and other respiratory outcomes.

Methods: This is an ongoing prospective observational study including infants born between 22 0/7-28 6/7 weeks GA. Neonates with congenital heart disease, genetic disorder, Pulmonary malformation or active pneumothorax were excluded. LUS using Brat et al scoring was obtained between days 5-9. Neonates were prospectively followed until discharge. Primary outcome was the NICHD BPD risk outcome estimator (2022), BPD grade (Jensen 2019), duration of mechanical ventilation. ROC curves and linear regression models were used to asses the association between the outcomes and LUS.

Results: A total of 30 infants are enrolled in the study, 2 were excluded (1-death, 1-CHD with Noonan syndrome). 4/28 fulfilled criteria for NICHD BPD risk outcome estimator probability of Grade 2-3 BPD or Death >50% (Risk >50%) calculated at day 7, and 9/28 neonates developed Grade 2-3 BPD in our cohort. AUC for risk >50% and LUS is 0.92, with 100% sensitivity and 75% specificity for LUS >8.5. AUC for predicting grade 2-3 BPD is 0.90, with 77.8% sensitivity and 84.2% specificity for LUS >8.5. (Figure1) Linear regression model showed a statistically significant correlation between duration of mechanical ventilation, total duration of respiratory support, and a weak relation with length of stay. (Table1)

Conclusion: Lung ultrasound score assessed between 5 to 9 days of age in preterm neonates < 29 weeks showed an association with NICHD BPD risk outcome estimator, development of grade 2-3 BPD, duration of ventilation, and length of stay. This information can be used in guiding measures to prevent BPD in preterm neonates.