Lung Ultrasound to Monitor Extremely Preterm Infants and Predict BPD: Multicenter Longitudinal Cohort Study

Lung ultrasound is useful in critically ill patients with acute respiratory failure. Given its characteristics, it could be also useful in extremely preterm infants with evolving chronic respiratory failure, as we lack accurate imaging tools to monitor them. To verify if lung ultrasound can monitor lung aeration and function, and has good reliability to predict bronchopulmonary dysplasia in extremely preterm neonates. Multicenter, international, prospective, longitudinal, cohort, diagnostic accuracy study consecutively enrolling inborn neonates with gestational age ≤30+6 weeks. Lung ultrasound was performed on the first, seventh, fourteenth and twenty-eighth days of life and lung ultrasound scores were calculated and correlated with simultaneous blood gases and work of breathing score. Gestational age-adjusted lung ultrasound scores were created, verified in multivariate models and subjected to ROC analyses to predict bronchopulmonary dysplasia at 36 weeks post-menstrual age. Mean lung ultrasound scores are different between infants developing (n=72) or not developing (n=75) BPD (p