WIP 68 - Predictive Ability of Lung Ultrasound Score for Response to Surfactant Replacement Therapy in Preterm Neonates ≤ 34 weeks gestation with Respiratory Distress Syndrome (PLUS-RDS study)

Publication Number: WIP 68.7677

Madhuri Gopal. Jhanwar, sir gangaram hospital, Delhi, Delhi, India; Anup Thakur, Sir Ganga Ram Hospital, New Delhi, New Delhi, Delhi, India; Satish Saluja, Sir Ganga Ram Hospital, NEW DELHI, Delhi, India; Neelam Kler, Sir GangaRam Hospital India, NEW DELHI, Delhi, India; Pankaj Garg, SIR GANGA RAM HOSPITAL, NEW DELHI, DELHI, Delhi, India; Manoj modi, Sir Ganga Ram Hospital, New Delhi, Delhi, India; arun soni, Department of Neonatology , Sir Ganga Ram Hospital, New Delhi, New Delhi, Delhi, India

Background: Respiratory distress syndrome (RDS) is a major cause of morbidity in preterm neonates. Surfactant replacement therapy (SRT) helps, but a subset of neonates may not respond. Lung Ultrasound, a bedside tool, can assess RDS severity and monitor SRT response. We aim to evaluate LUS for predicting response to SRT in neonates ≤34 weeks.

Objective: Primary outcome was to study the predictive ability of lung USG score for response to surfactant replacement therapy in preterm neonates ≤ 34 weeks with respiratory distress syndrome, requiring respiratory support within 6 hours of birth. Secondary outcomes were predictive ability of LUS to identify neonates who would need FiO2 > 0.30 in first 6 hours of life, predictive ability of lung USG score for successful extubation in first 72 hrs of life defined as no requirement of invasive ventilation till 48 hours following extubation, LUS pre-surfactant and 6 hours post surfactant therapy and correlation of LUS with oxygenation indices pre-surfactant and 6 hours post surfactant therapy.

Design/Methods: This prospective observational study, conducted in a level IIIB NICU in India from August 2023, aims to enroll 65 preterm neonates (≤34 weeks gestation) needing respiratory support within 6 hours of birth. Exclusion criteria include neonates < 26 weeks, with suspected anomalies, meconium aspiration, congenital pneumonia, those requiring delivery room surfactant or extensive resuscitation, and those without parental consent. Study is approved by the institutional ethics committee and registered with CTRI. Lung USG was done and scoring from 0–18 was given to enrolled neonates based on Lichtenstein criteria. Data analysis (SPSS v28) uses Kendall’s W for agreement among investigators, Pearson for correlation, and ROC curves for LUS cut-off. Statistical significance was set at p < 0.05.