Evaluation of surfactant replacement therapy effects: A new potential role of lung ultrasound

Abstract

INTRODUCTION: Previous studies suggested that effects of the surfactant administration in preterm intants with respiratory distress syndrome cannot be followed by lung ultrasound (L-US). OBJECTIVE: The aim of the paper is to evaluate the surfactant replacement therapy effects using a new, proposed grading system for L-US findings. METHODS: We report the series of 12 preterm infants with clinical and radiographic signs of respiratory distress syndrome, in whom L-US examinations were performed prior to, and within the first 24 hours after surfactant administration. To evaluate the surfactant replacement therapy effects, we proposed a new grading system (1 to 6) for L-US findings at each examined lung area, based on the presence of normal finding, the amount of B-lines and subpleural consolidations. RESULTS: All preterm infants had an improvement of L-US findings from one to four grades observed within the first 24 hours after surfactant administration, which has not been previously reported. The improvement of L-US findings was most commonly observed in anterior lung areas. CONCLUSION: L-US might enable an early detection of the surfactant replacement therapy effects. Further prospective studies are necessary to define the role of L-US in this field.