Association of lung ultrasound score with large patent ductus arteriosus in preterm neonates during the transitional period.

Recent studies suggested lung ultrasound (LU) as a useful, non-invasive bedside tool for assessing pulmonary edema; however, its utility in identifying preterm neonates with large patent ductus arteriosus (L-PDA) is limited. The objective of the study is to evaluate the association of LU score (LUS) in preterm neonates with L-PDA during the transitional period and explore correlation of LUS with echocardiographic indicators. Among 152 neonates born < 29 weeks' gestation and had LU performed at day-of-life (DOL) three for a previous prospective study, 54 neonates had concomitant echocardiography (Echo) documenting PDA presence, diameter, and variables for shunt volume. We included in the analysis neonates who had LU and Echo on DOL 3. Neonates with L-PDA were compared to those with absent or small PDA. Univariate, multivariate, and Pearson's correlation coefficients analyses were conducted. Of the 54 infants included in the study, 32 (59%) were diagnosed with L-PDA. There were no significant differences in baseline characteristics between the L-PDA and no-L-PDA group. Univariate analysis showed no association between LUS and L-PDA. Similarly, multivariate analysis found that a one-point increment of LUS was not associated to L-PDA (adjusted OR 1.19; 95% CI 0.89-1.59). LUS demonstrated a significant correlation with respiratory severity score and a weak correlation with PDA diameter, but no significant associations with other PDA shunt volume variables.

conclusionIn this cohort, LUS was not associated with L-PDA during the transition period. Larger studies are required to confirm these findings and further explore the clinical utility of LUS in assessing PDA. WHAT IS KNOWN: • Lung ultrasound (LUS) is a non-invasive tool for assessing pulmonary edema in preterm neonates. • Previous studies have reported a positive correlation between LUS score and hemodynamically significant PDA. WHAT IS NEW: • In this cohort of preterm neonates 29 weeks, LUS was not associated with large PDA during the transitional period (DOL 3). • LUS showed correlation with respiratory severity but not with echocardiographic markers of PDA shunt volume.