1Senior Resident, Department of Paediatrics, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak.
2Professor, Department of Pediatrics, School of Medical Sciences & Research, Sharda Hospital, Sharda University, Greater Noida
3*Associate Professor, Department of Pediatrics, School of Medical Sciences & Research, Sharda Hospital, Sharda University, Greater Noida (Corresponding Author)
4Associate Professor, Department of Radiology, School of Medical Sciences & Research, Sharda Hospital, Sharda University, Greater Noida
5Associate Professor, Department of Radiology, School of Medical Sciences & Research, Sharda Hospital, Sharda University, Greater Noida
6HOD & Professor, Department of Pediatrics, School of Medical Sciences & Research, Sharda Hospital, Sharda University, Greater Noida
7Professor, Department of Pediatrics, School of Medical Sciences & Research, Sharda Hospital, Sharda University, Greater Noida
AIM- To estimate cut off value of lung ultrasound score for neonates less than 34 weeks of gestation with Respiratory Distress Syndrome.
METHODOLOGY- All preterm neonates (<34 weeks gestation), both inborn and outborn, admitted to the NICU with respiratory distress were prospectively enrolled after obtaining informed parental consent. Antenatal and perinatal history, delivery details, and risk factors were recorded. Lung ultrasound (LUS) was performed within 4 hours of admission using a GE LOGIQ P3 portable ultrasound machine with a high-frequency linear probe (6–12 MHz). Each lung was divided into anterior, lateral, and posterior zones (six zones total), and examined in longitudinal and transverse planes. Each zone was assigned a score from 0 to 3 based on lung aeration pattern: 0 = A-lines only (normal aeration); 1 = ≥3 well-spaced B-lines; 2 = coalescent B-lines with or without limited subpleural consolidation; 3 = extended consolidation/white lung. The total LUS score ranged from 0 to 18.
RESULT- In our study of 78 neonates, LUS scores ranged from 3 to 13, with 55.1% requiring surfactant. Most neonates (85.9%) were managed with CPAP, while 14.1% required mechanical ventilation (MV); all MV cases also needed surfactant and had higher mortality (27%) and LUS scores. A LUS cut-off >9 was statistically significant (p < 0.001) for predicting surfactant need, with 93.02% sensitivity and 91.43% specificity. Surfactant use increased with higher LUS scores, and all neonates with LUS >11 required it. Lower LUS scores (3–8) were observed in those with antenatal steroid coverage. A significant correlation was found between LUS and SAS, with higher scores in neonates needing surfactant.
CONCLUSION- Lung ultrasound (LUS) is a non-invasive, bedside, and repeatable tool that is increasingly recognized for its effectiveness in managing neonatal respiratory distress. It offers greater predictive value for intubation than chest x-ray, with key findings like lung consolidation, pleural line abnormalities, and absence of A-lines being highly specific for respiratory distress syndrome (RDS). LUS also reduces reliance on chest radiographs, thereby minimizing radiation exposure in vulnerable preterm infants. As a reliable and radiation-free imaging modality, LUS is valuable for both diagnosing and monitoring RDS and should be used alongside x-rays to improve neonatal care.
Keywords: Lung Ultrasound, Preterm Neonates, Respiratory Distress Syndrome, Surfactant, LUS Score, CPAP, Mechanical Ventilation
How to cite this article: Dr. Sonakshi, Dr. Shashi Bhushan, Dr. Praneta Swarup, Dr. Amit Gupta, Dr. Khemendra Kumar, Dr. Rajeev Kumar Thapar, Dr. Bindu T Nair: Ultrasound As The Guiding Light: Establishing A LUS Cut Off For Surfactant Use In Preterm Neonates With Respiratory Distress. Int J Drug Deliv Technol. 2026; 16(5s): 943-949; DOI: 10.25258/ijddt.16.5s.116
Source of support: Nil.
Conflict of interest: Nil.