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Prediction of Extubation Readiness Using Transthoracic Ultrasound in Preterm Infants
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  • Reem Soliman,
  • Yasser Elsayed,
  • Reem Said,
  • Abdulaziz Abdulbaqi,
  • Rania Hashem,
  • Hany Aly
Reem Soliman
Cairo University Kasr Alainy Faculty of Medicine
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Yasser Elsayed
University of Manitoba College of Medicine
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Reem Said
Cairo University Kasr Alainy Faculty of Medicine
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Abdulaziz Abdulbaqi
Cairo University Kasr Alainy Faculty of Medicine
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Rania Hashem
Cairo University Kasr Alainy Faculty of Medicine
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Hany Aly
Cleveland Clinic Children's Hospital
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Abstract

We aimed to test the hypothesis that a lung ultrasound severity score (LUS) and assessment of left ventricular eccentricity index of the interventricular septum (LVEI) by focused heart ultrasound can predict extubation success in mechanically ventilated infants. We conducted a prospective study on premature infants <34 weeks’ of gestation. LUS was performed on postnatal days 3 and 7 by an investigator who was masked to infants’ ventilator parameters. LVEI and pulmonary artery pressure (PAP) were measured at postnatal day 3. A receiver operator curve was constructed to assess the ability to predict extubation success. Spearman correlation was performed between LVEI and PAP. A total of 104 studies were performed to 66 infants; of them 39 had mild and 65 had moderate-severe lung disease. LUS predicted extubation success with a sensitivity and a specificity of 91% and 69%, respectively. Area under the curve was 0.83 (CI: 0.75-0.91). LVEI did not differ between infants that succeeded and failed extubation. It correlated with PAP during systole (r=0.66). We conclude that LUS predicts extubation success in mechanically ventilated preterm infants whereas LVEI correlates with high PAP.

Peer review status:ACCEPTED

30 Dec 2020Submitted to Pediatric Pulmonology
04 Jan 2021Submission Checks Completed
04 Jan 2021Assigned to Editor
07 Jan 2021Reviewer(s) Assigned
28 Jan 2021Review(s) Completed, Editorial Evaluation Pending
30 Jan 2021Editorial Decision: Revise Major
11 Mar 20211st Revision Received
15 Mar 2021Submission Checks Completed
15 Mar 2021Assigned to Editor
15 Mar 2021Reviewer(s) Assigned
19 Mar 2021Review(s) Completed, Editorial Evaluation Pending
20 Mar 2021Editorial Decision: Accept