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 infants 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.