Lung ultrasound (LUS) and surfactant treatment: looking for the best predictive moment

Objective: Assess the earliest time of LUS to guide surfactant therapy. Study design: In this observational study (ClinicalTrials.gov Identifier NCT04544514), LUS was performed within 30 min and repeated at 1, 2, 4, and 6 h on preterm babies. White lung appearance was defined as type 1 group, whereas prevalence of lines B as type 2 and lines A as type 3. Ultrasound and radiographic findings were also compared to determine surfactant need. Results: Among 71 patients, 41 received surfactant therapy. In the first evaluation, 37 of them have been defined as type 1, whereas 4 of them have been as type 2 group. Type 3 group did not receive surfactant. Type 1 findings were superior to predict surfactant need and the predictive value was 100% at 2 h. Conclusion: Even early LUS assessment at the first 20–30 min was more significant to predict surfactant need than x-ray. Presence of white lung appearance for 2 h indicates an absolute surfactant need.