Point of care lung ultrasound service in neonatal intensive care: Five years of experience in Manitoba, Canada.

OBJECTIVE: To evaluate the utility of a point of care lung ultrasound (POC-LUS) on patient management in the Neonatal Intensive Care Unit (NICU). STUDY DESIGN: A retrospective cohort study of neonates who had POC-LUS from 2016 to 2020 in two-level III NICUs in Winnipeg, Manitoba, Canada. The primary outcome was the change in clinical management. The analysis aims mainly to describe the implementation process of the POC-LUS program. RESULTS: A total of 956 neonates underwent 4076 POC-LUS studies during the study period. The number of POC-LUS studies increased significantly every year, from 316 (in 2016) to 1257 (in 2020) (p < 0.001). POC-LUS resulted in a change in clinical management following 2528 POC-LUS studies (62%), while it supported continuing the same management in 1548 studies (38%). CONCLUSION: POC-LUS in Manitoba increased since its inception and led to an alteration in the clinical management in a significant proportion of patients who received the service.

Lung Ultrasound for Prediction of Bronchopulmonary Dysplasia in Extreme Preterm Neonates: A Prospective Diagnostic Cohort Study.

OBJECTIVES: To evaluate the diagnostic and predictive ability of lung ultrasound at 3 time points in the first 2 weeks after birth for predicting bronchopulmonary dysplasia (BPD) among infants <29 weeks of gestational age. STUDY DESIGN: This was a prospective, diagnostic cohort study. Lung ultrasound was performed on days 3, 7, and 14 after birth and lung ultrasound scores (LUS) were calculated in blinded fashion. Diagnostic test characteristics and area under receiver operating characteristic (AUROC) curves were calculated. RESULTS: A total of 152 infants were enrolled with mean (SD) gestational age of 25.8 (1.5) weeks gestation. Of them, 87 (57%) infants were diagnosed with BPD. The LUS were significantly higher in infants diagnosed with BPD compared with those without BPD at all scan time points (P < .01). The score of >10 at all 3 time points had higher sensitivity (0.89, 0.89, and 0.77), specificity (0.87, 0.90, and 0.92), and corresponding clinically important positive and negative likelihood ratios. The AUROC for LUS at the 3 time points were 0.96, 0.97, and 0.95 on day 3, 7, and 14, respectively. Compared with the model using clinical characteristics, LUS alone had higher AUROC (P < .05 for all 3 time points). CONCLUSIONS: In this cohort, LUS in the first 2 weeks after birth had a very high predictive value for the diagnosis of BPD among infants of <29 weeks of gestation. TRIAL REGISTRATION: ClinicalTrials.govNCT04756297.