The objective of the study is to evaluate the role of neonatologist-performed lung ultrasound (NPLUS) after weaning from invasive mechanical ventilation and extubation. Our aim is to study the diagnostic accuracy of NPLUS and investigate whether LUS leads to earlier actions before clinical deterioration and hence prevents extubation failure.
All preterm and full-term neonates receiving invasive mechanical ventilation at the Division of Neonatology of the Medical University of Graz AND
Written informed consent was obtained from parents prior to extubation
None
Parallel
NPLUS (neonatologist performed lung ultrasound)
Other interventionNPLUS is conducted with an ultrasound scanner using a high-frequency (12-15 MHz) linear transducer probe (scanning depth approximately 4-5 cm). The neonate is placed in a supine position. The anterior, lateral and posterior chest areas are scanned using the presets "lung" or "small parts". Landmarks are the anterior and posterior axillary line (longitudinal) on each hemithorax. A sequential scan from right to left, anterior to posterior is performed. (6 lung areas). In the study NPLUS is performed to quantify the lung ultrasound score at time points T0, T1 and T2. Sequences of 3-5 seconds are saved and assessed according to the lung ultrasound score adapted by Rodriguez-Fanjul et al. (0- to 3 point score for each area, resulting in a total score ranging from 0 to 18). To ensure inter-observer reliability the anonymous video sequences are then rated by two independent neonatologists.
Reintubation rate (within 72 hours after extubation)
Mode of respiratory support
NCPAP, DUOPAP or BILEVEL during 72 hours after extubation
Respiratory settings- FiO2
FiO2 (fraction of inspired oxygen) during 72 hours after extubation
Respiratory settings- PEEP
PEEP (Positive EndExpiratory Pressure) during 72 hours after extubation
SpO2/FiO2 ratio
Ratio of arterial oxygen saturation and fraction of inspired oxygen
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