The Accuracy of Various Lung Ultrasonography Findings in Predicting the Necessity for Surfactant Treatment in Neonates With Respiratory Distress Syndrome

Objective: The study was conducted to determine the value of various lung ultrasonography (LUS) findings in diagnosing neonatal respiratory distress syndrome (RDS) and to assess the ability of ultrasonography to predict the need for surfactant treatment. Materials and Methods: This cohort study was conducted on 164 neonates with RDS with a gestational age of over 28 weeks. Transthoracic sonography was performed in all patients in the infant isolet immediately after admission and stabilization of the infant and during the first 6 hours before surfactant treatment. Immediately after the sonogram, the neonates underwent an anterior–posterior view chest radiograph, before and after surfactant treatment. Results: In comparison with clinical manifestations and radiographic findings as the references, the sensitivity and specificity of each of the LUS-related parameters for detecting RDS were as follows: Faded A-lines (95.4% and 76.7%), abnormal B-lines (91.7% and 71.6%), the presence of consolidation (90.9% and 88.3%), the presence of pleural effusion (95% and 86.7%), and alveolar–interstitial syndrome (AIS) (98% and 96%). Conclusion: LUS findings were valuable in assessing and grading the severity of neonatal RDS alongside clinical evaluation. LUS may assist in selecting infants for surfactant therapy and monitoring treatment response.