肺脏超声对新生儿呼吸窘迫综合征撤机的价值

Value of lung ultrasonography to predict weaning success in neonatal respiratory distress syndrome

目的:探讨肺脏超声在新生儿呼吸窘迫综合征患儿中的撤机时机。方法:选取2021年1月—2022年2月广东医科大学附属惠东医院新生儿科收治的75例患有新生儿呼吸窘迫综合征需要有创呼吸机的新生儿。收集新生儿的人口学资料,血气值及肺脏超声评分。所有患者均于拔管前2 h内行肺超声检查,计算所有新生儿肺超声评分。拔管前也进行了血气检查。结果:新生儿拔管失败16例,失败新生儿肺脏超声评分明显高于成功组,而且胎龄明显较低,体重较轻,呼吸机通气持续时间明显延长。在截断值≤14.5时,拔管前LUS预测新生儿撤机成功率为93.8%,特异性为76.3%,ROC曲线下面积0.932。结论:LUS能够帮助新生儿呼吸机窘迫综合征的患儿准确有效的撤离有创呼吸机。

Objective To investigate the role of lung ultrasound in guiding the timing of withdrawal in newborns with neonatal respiratory distress syndrome.Methods From January 2021 to February 2022,75 newborns with neonatal respiratory distress syndrome who needed invasive ventilator were admitted to the Department of neonatal pediatrics of Huidong Hospital Affiliated to Guangdong Medical University.Demographic data,blood gas values and lung ultrasound scores were collected from the neonates.All patients underwent lung ultrasound within 2 hours before extubation,and lung ultrasound scores were calculated for all neonates.Blood gas examination was also performed before extubation.Results 16 neonates experienced extubation failure.Neonates with extubation failure had higher score,significantly lower gestational age,lower weight but significantly prolonged duration of mechanical ventilation.Pre-extubation LUS had a sensitivity of 93.8%and a specificity of 76.3%to predict weaning success in neonates at a cutoff value≤14.5,the area under ROC curve is 0.932.Conclusion Lung ultrasound is a reliable tool for predicting weaning success of neonatal respiratory distress syndrome in neonates.