Accuracy of lung ultrasound in predicting successful extubation in preterm infants born ≤ 25 weeks.

Objective: The aim of this study was to examine the predictive value of the lung ultrasound score (LUS) for successful extubation in preterm infants born at ≤25+6 weeks.

Methods: This was a single-center, prospective cohort study. Preterm infants with gestational age (GA) ≤ 25+6 weeks who received invasive mechanical ventilation (IMV) for ≥72 h were included. Lung ultrasound was performed every day. Multivariate logistic regression analysis was used to evaluate factors that predict extubation outcomes.

Results: Ninety-three infants with GA ≤ 25+6 weeks were included. The mean GA was 24.5 ± 1.2 weeks. Extubation failure occurred in 55 (59.1%) neonates, and success occurred in 38 (40.9%) neonates. The LUS was significantly lower in the successful group than in the failed group (24.0 ± 2.5 vs. 32.1 ± 3.1 p < 0.001). Logistic regression analysis showed that LUS was an independent predictor of successful extubation (odd ratio 0.15 [95% CI 0.045-0.508], P = 0.002). The area under the receiver operating characteristic curve was 0.98 (p < 0.001) for LUS, and a cutoff value of ≥ 28 had 94.6% sensitivity and 92.7% specificity in detecting extubation failure.

Conclusions: The LUS has good accuracy for predicting successful extubation in extremely preterm infants with GA ≤ 25+6 weeks.