Loading…
Accuracy of lung and diaphragm ultrasound in predicting successful extubation in extremely preterm infants: A prospective observational study
Objective Chest ultrasound has emerged as a promising tool in predicting extubation readiness in adults and children, yet its utility in preterm infants is lacking. Our aim was to assess the utility of lung ultrasound severity score (LUSS) and diaphragmatic function in predicting extubation readines...
Saved in:
| Published in: | Pediatric pulmonology 2023-02, Vol.58 (2), p.530-539 |
|---|---|
| Main Authors: | , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c3573-667ec033eaeb58e3187196dbce34ee7f23622668d5fd01f7f9483bf1c9c3810e3 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c3573-667ec033eaeb58e3187196dbce34ee7f23622668d5fd01f7f9483bf1c9c3810e3 |
| container_end_page | 539 |
| container_issue | 2 |
| container_start_page | 530 |
| container_title | Pediatric pulmonology |
| container_volume | 58 |
| creator | Mohsen, Nada Nasef, Nehad Ghanem, Mohab Yeung, Telford Deekonda, Veena Ma, Carmen Kajal, Dilkash Baczynski, Michelle Jain, Amish Mohamed, Adel |
| description | Objective
Chest ultrasound has emerged as a promising tool in predicting extubation readiness in adults and children, yet its utility in preterm infants is lacking. Our aim was to assess the utility of lung ultrasound severity score (LUSS) and diaphragmatic function in predicting extubation readiness in extremely preterm infants.
Study Design
In this prospective cohort study, preterm infants |
| doi_str_mv | 10.1002/ppul.26223 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2731721941</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2768129242</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3573-667ec033eaeb58e3187196dbce34ee7f23622668d5fd01f7f9483bf1c9c3810e3</originalsourceid><addsrcrecordid>eNp9kc1O3TAQhS3UqtxCNzxAZambqlKox06cmN0VgrbSlcoC1pHjjCHI-cGOoXmIvnMdLnTRRVcjH39zNDOHkBNgp8AY_zpN0Z1yybk4IBtgSmUsV_IN2VRlUWSykuKQvA_hnrH0p-AdORRS8JwDbMjvrTHRa7PQ0VIXh1uqh5a2nZ7uvL7taXSz12GMSewGOnlsOzN3CQvRGAzBRkfx1xwbPXfjsDLp5bFHt6z0jL5PotXDHM7oNkljmDA5PCIdm4D-8blPOxrm2C7H5K3VLuCHl3pEbi4vrs-_Z7uf336cb3eZEUUpMilLNEwI1NgUFQqoSlCybQyKHLG0XKRjSFm1hW0Z2NKqvBKNBaOMqIChOCKf975pnoeIYa77Lhh0Tg84xlDzUkDJQeWQ0E__oPdj9GnilZIVcJUumagve8qkBYNHW0--67VfamD1GlK9hlQ_h5Tgjy-Wsemx_Yu-ppIA2ANPncPlP1b11dXNbm_6B4xgn9k</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2768129242</pqid></control><display><type>article</type><title>Accuracy of lung and diaphragm ultrasound in predicting successful extubation in extremely preterm infants: A prospective observational study</title><source>Wiley</source><creator>Mohsen, Nada ; Nasef, Nehad ; Ghanem, Mohab ; Yeung, Telford ; Deekonda, Veena ; Ma, Carmen ; Kajal, Dilkash ; Baczynski, Michelle ; Jain, Amish ; Mohamed, Adel</creator><creatorcontrib>Mohsen, Nada ; Nasef, Nehad ; Ghanem, Mohab ; Yeung, Telford ; Deekonda, Veena ; Ma, Carmen ; Kajal, Dilkash ; Baczynski, Michelle ; Jain, Amish ; Mohamed, Adel</creatorcontrib><description>Objective
Chest ultrasound has emerged as a promising tool in predicting extubation readiness in adults and children, yet its utility in preterm infants is lacking. Our aim was to assess the utility of lung ultrasound severity score (LUSS) and diaphragmatic function in predicting extubation readiness in extremely preterm infants.
Study Design
In this prospective cohort study, preterm infants < 28 weeks gestational age (GA) who received invasive mechanical ventilation for ≥12 h were enrolled. Chest ultrasound was performed before extubation. The primary outcome was lung ultrasound accuracy for predicting successful extubation at 3 days. Descriptive statistics and logistic regression were done using SPSS version 22.
Results
We enrolled 45 infants, of whom 36 (80%) were successfully extubated. GA and postmenstrual age (PMA) at extubation were significantly higher in the successful group. The LUSS was significantly lower in the successful group compared to failed group (11.9 ± 3.2 vs. 19.1 ± 3.1 p < 0.001). The two groups had no statistically significant difference in diaphragmatic excursion or diaphragmatic thickness fraction. Logistic regression analysis controlling for GA and PMA at extubation showed LUSS was an independent predictor for successful extubation (odd ratio 0.46, 95% confidence interval [0.23–0.9], p = 0.02). The area under the receiver operating characteristic curve was 0.95 (p ˂ 0.001) for LUSS, and a cut‐off value of ≥15 had 95% sensitivity and 85% specificity in detecting extubation failure.
Conclusion
In extremely preterm infants, lung ultrasound has good accuracy for predicting successful extubation. However, diaphragmatic measurements were not reliable predictors.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.26223</identifier><identifier>PMID: 36324211</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Accuracy ; Adult ; Airway Extubation ; Child ; Diaphragm - diagnostic imaging ; diaphragm ultrasound ; Extubation ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Lung - diagnostic imaging ; lung ultrasound ; Newborn babies ; Observational studies ; Premature babies ; Preterm infant ; Prospective Studies ; Regression analysis ; Respiration, Artificial ; Ultrasonic imaging ; Ventilator Weaning</subject><ispartof>Pediatric pulmonology, 2023-02, Vol.58 (2), p.530-539</ispartof><rights>2022 Wiley Periodicals LLC.</rights><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3573-667ec033eaeb58e3187196dbce34ee7f23622668d5fd01f7f9483bf1c9c3810e3</citedby><cites>FETCH-LOGICAL-c3573-667ec033eaeb58e3187196dbce34ee7f23622668d5fd01f7f9483bf1c9c3810e3</cites><orcidid>0000-0002-8090-7213 ; 0000-0001-8031-6627</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36324211$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mohsen, Nada</creatorcontrib><creatorcontrib>Nasef, Nehad</creatorcontrib><creatorcontrib>Ghanem, Mohab</creatorcontrib><creatorcontrib>Yeung, Telford</creatorcontrib><creatorcontrib>Deekonda, Veena</creatorcontrib><creatorcontrib>Ma, Carmen</creatorcontrib><creatorcontrib>Kajal, Dilkash</creatorcontrib><creatorcontrib>Baczynski, Michelle</creatorcontrib><creatorcontrib>Jain, Amish</creatorcontrib><creatorcontrib>Mohamed, Adel</creatorcontrib><title>Accuracy of lung and diaphragm ultrasound in predicting successful extubation in extremely preterm infants: A prospective observational study</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description>Objective
Chest ultrasound has emerged as a promising tool in predicting extubation readiness in adults and children, yet its utility in preterm infants is lacking. Our aim was to assess the utility of lung ultrasound severity score (LUSS) and diaphragmatic function in predicting extubation readiness in extremely preterm infants.
Study Design
In this prospective cohort study, preterm infants < 28 weeks gestational age (GA) who received invasive mechanical ventilation for ≥12 h were enrolled. Chest ultrasound was performed before extubation. The primary outcome was lung ultrasound accuracy for predicting successful extubation at 3 days. Descriptive statistics and logistic regression were done using SPSS version 22.
Results
We enrolled 45 infants, of whom 36 (80%) were successfully extubated. GA and postmenstrual age (PMA) at extubation were significantly higher in the successful group. The LUSS was significantly lower in the successful group compared to failed group (11.9 ± 3.2 vs. 19.1 ± 3.1 p < 0.001). The two groups had no statistically significant difference in diaphragmatic excursion or diaphragmatic thickness fraction. Logistic regression analysis controlling for GA and PMA at extubation showed LUSS was an independent predictor for successful extubation (odd ratio 0.46, 95% confidence interval [0.23–0.9], p = 0.02). The area under the receiver operating characteristic curve was 0.95 (p ˂ 0.001) for LUSS, and a cut‐off value of ≥15 had 95% sensitivity and 85% specificity in detecting extubation failure.
Conclusion
In extremely preterm infants, lung ultrasound has good accuracy for predicting successful extubation. However, diaphragmatic measurements were not reliable predictors.</description><subject>Accuracy</subject><subject>Adult</subject><subject>Airway Extubation</subject><subject>Child</subject><subject>Diaphragm - diagnostic imaging</subject><subject>diaphragm ultrasound</subject><subject>Extubation</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Extremely Premature</subject><subject>Infant, Newborn</subject><subject>Lung - diagnostic imaging</subject><subject>lung ultrasound</subject><subject>Newborn babies</subject><subject>Observational studies</subject><subject>Premature babies</subject><subject>Preterm infant</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Respiration, Artificial</subject><subject>Ultrasonic imaging</subject><subject>Ventilator Weaning</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kc1O3TAQhS3UqtxCNzxAZambqlKox06cmN0VgrbSlcoC1pHjjCHI-cGOoXmIvnMdLnTRRVcjH39zNDOHkBNgp8AY_zpN0Z1yybk4IBtgSmUsV_IN2VRlUWSykuKQvA_hnrH0p-AdORRS8JwDbMjvrTHRa7PQ0VIXh1uqh5a2nZ7uvL7taXSz12GMSewGOnlsOzN3CQvRGAzBRkfx1xwbPXfjsDLp5bFHt6z0jL5PotXDHM7oNkljmDA5PCIdm4D-8blPOxrm2C7H5K3VLuCHl3pEbi4vrs-_Z7uf336cb3eZEUUpMilLNEwI1NgUFQqoSlCybQyKHLG0XKRjSFm1hW0Z2NKqvBKNBaOMqIChOCKf975pnoeIYa77Lhh0Tg84xlDzUkDJQeWQ0E__oPdj9GnilZIVcJUumagve8qkBYNHW0--67VfamD1GlK9hlQ_h5Tgjy-Wsemx_Yu-ppIA2ANPncPlP1b11dXNbm_6B4xgn9k</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>Mohsen, Nada</creator><creator>Nasef, Nehad</creator><creator>Ghanem, Mohab</creator><creator>Yeung, Telford</creator><creator>Deekonda, Veena</creator><creator>Ma, Carmen</creator><creator>Kajal, Dilkash</creator><creator>Baczynski, Michelle</creator><creator>Jain, Amish</creator><creator>Mohamed, Adel</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8090-7213</orcidid><orcidid>https://orcid.org/0000-0001-8031-6627</orcidid></search><sort><creationdate>202302</creationdate><title>Accuracy of lung and diaphragm ultrasound in predicting successful extubation in extremely preterm infants: A prospective observational study</title><author>Mohsen, Nada ; Nasef, Nehad ; Ghanem, Mohab ; Yeung, Telford ; Deekonda, Veena ; Ma, Carmen ; Kajal, Dilkash ; Baczynski, Michelle ; Jain, Amish ; Mohamed, Adel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3573-667ec033eaeb58e3187196dbce34ee7f23622668d5fd01f7f9483bf1c9c3810e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Accuracy</topic><topic>Adult</topic><topic>Airway Extubation</topic><topic>Child</topic><topic>Diaphragm - diagnostic imaging</topic><topic>diaphragm ultrasound</topic><topic>Extubation</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Extremely Premature</topic><topic>Infant, Newborn</topic><topic>Lung - diagnostic imaging</topic><topic>lung ultrasound</topic><topic>Newborn babies</topic><topic>Observational studies</topic><topic>Premature babies</topic><topic>Preterm infant</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Respiration, Artificial</topic><topic>Ultrasonic imaging</topic><topic>Ventilator Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mohsen, Nada</creatorcontrib><creatorcontrib>Nasef, Nehad</creatorcontrib><creatorcontrib>Ghanem, Mohab</creatorcontrib><creatorcontrib>Yeung, Telford</creatorcontrib><creatorcontrib>Deekonda, Veena</creatorcontrib><creatorcontrib>Ma, Carmen</creatorcontrib><creatorcontrib>Kajal, Dilkash</creatorcontrib><creatorcontrib>Baczynski, Michelle</creatorcontrib><creatorcontrib>Jain, Amish</creatorcontrib><creatorcontrib>Mohamed, Adel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mohsen, Nada</au><au>Nasef, Nehad</au><au>Ghanem, Mohab</au><au>Yeung, Telford</au><au>Deekonda, Veena</au><au>Ma, Carmen</au><au>Kajal, Dilkash</au><au>Baczynski, Michelle</au><au>Jain, Amish</au><au>Mohamed, Adel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of lung and diaphragm ultrasound in predicting successful extubation in extremely preterm infants: A prospective observational study</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2023-02</date><risdate>2023</risdate><volume>58</volume><issue>2</issue><spage>530</spage><epage>539</epage><pages>530-539</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract>Objective
Chest ultrasound has emerged as a promising tool in predicting extubation readiness in adults and children, yet its utility in preterm infants is lacking. Our aim was to assess the utility of lung ultrasound severity score (LUSS) and diaphragmatic function in predicting extubation readiness in extremely preterm infants.
Study Design
In this prospective cohort study, preterm infants < 28 weeks gestational age (GA) who received invasive mechanical ventilation for ≥12 h were enrolled. Chest ultrasound was performed before extubation. The primary outcome was lung ultrasound accuracy for predicting successful extubation at 3 days. Descriptive statistics and logistic regression were done using SPSS version 22.
Results
We enrolled 45 infants, of whom 36 (80%) were successfully extubated. GA and postmenstrual age (PMA) at extubation were significantly higher in the successful group. The LUSS was significantly lower in the successful group compared to failed group (11.9 ± 3.2 vs. 19.1 ± 3.1 p < 0.001). The two groups had no statistically significant difference in diaphragmatic excursion or diaphragmatic thickness fraction. Logistic regression analysis controlling for GA and PMA at extubation showed LUSS was an independent predictor for successful extubation (odd ratio 0.46, 95% confidence interval [0.23–0.9], p = 0.02). The area under the receiver operating characteristic curve was 0.95 (p ˂ 0.001) for LUSS, and a cut‐off value of ≥15 had 95% sensitivity and 85% specificity in detecting extubation failure.
Conclusion
In extremely preterm infants, lung ultrasound has good accuracy for predicting successful extubation. However, diaphragmatic measurements were not reliable predictors.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36324211</pmid><doi>10.1002/ppul.26223</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-8090-7213</orcidid><orcidid>https://orcid.org/0000-0001-8031-6627</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 8755-6863 |
| ispartof | Pediatric pulmonology, 2023-02, Vol.58 (2), p.530-539 |
| issn | 8755-6863 1099-0496 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2731721941 |
| source | Wiley |
| subjects | Accuracy Adult Airway Extubation Child Diaphragm - diagnostic imaging diaphragm ultrasound Extubation Humans Infant Infant, Extremely Premature Infant, Newborn Lung - diagnostic imaging lung ultrasound Newborn babies Observational studies Premature babies Preterm infant Prospective Studies Regression analysis Respiration, Artificial Ultrasonic imaging Ventilator Weaning |
| title | Accuracy of lung and diaphragm ultrasound in predicting successful extubation in extremely preterm infants: A prospective observational study |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T04%3A31%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Accuracy%20of%20lung%20and%20diaphragm%20ultrasound%20in%20predicting%20successful%20extubation%20in%20extremely%20preterm%20infants:%20A%20prospective%20observational%20study&rft.jtitle=Pediatric%20pulmonology&rft.au=Mohsen,%20Nada&rft.date=2023-02&rft.volume=58&rft.issue=2&rft.spage=530&rft.epage=539&rft.pages=530-539&rft.issn=8755-6863&rft.eissn=1099-0496&rft_id=info:doi/10.1002/ppul.26223&rft_dat=%3Cproquest_cross%3E2768129242%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3573-667ec033eaeb58e3187196dbce34ee7f23622668d5fd01f7f9483bf1c9c3810e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2768129242&rft_id=info:pmid/36324211&rfr_iscdi=true |