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

Journal of Perinatology volume 45, pages 830–836 (2025)Cite this article

Subjects

Abstract

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.

Conclusion

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

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Fig. 1: Five patterns of neonatal lung ultrasound.
Fig. 2
Fig. 3: Prediction of extubation success by lung ultrasound score.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank the staff who participated in this study.

Funding

This study is supported by Shenzhen Science and Technology Program (JCYJ20230807120201004 to H.Z), Shenzhen Fund for Guangdong Provincial Highlevel Clinical Key Specialties (No.SZGSP009), Sanming Project of Medicine in Shenzhen (No.SZSM202211001), Shenzhen Key Laboratory of Maternal and Child Health and Diseases (ZDSYS 20230626091559006).

Author information

Authors and Affiliations

  1. Neonatal Intensive Care Unit, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, Guangdong Province, China

    Haifeng Zong, Bingchun Lin, Yingsui Huang, Yichu Huang, Hongyan Sun, Qingling Xu & Chuanzhong Yang

  2. Women and Children’s Medical Center, Southern Medical University, Shenzhen, 518028, Guangdong Province, China

    Haifeng Zong, Bingchun Lin, Yingsui Huang, Yichu Huang, Hongyan Sun, Qingling Xu & Chuanzhong Yang

  3. Youth Innovation Team of Medical Bioinformatics, Shenzhen University Health Science Center, Shenzhen, 518060, China

    Zile Lin & Jiamin Wu

Authors
  1. Haifeng Zong
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Contributions

Each author made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data. CY conceived and designed the study. BL, YH, YH, HS ZL, JW and QX acquired data and analyzed data. The preliminary draft of the manuscript was prepared by HZ, BL, YH, and CY. All authors gave their approval for the final version of the manuscript.

Corresponding author

Correspondence to Chuanzhong Yang.

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Competing interests

The authors declare no competing interests.

Ethics statement

This study was performed in line with the principles of the declaration on Helsinki. The study was approved by the ethics committee of the hospital (No. SFYLJ2023048).

Informed consent

The study was approved by the Ethics Committee of the Shenzhen Maternity & Child Healthcare Hospital. and written informed consent was obtained from the parents.

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Zong, H., Lin, B., Huang, Y. et al. Accuracy of lung ultrasound in predicting successful extubation in preterm infants born ≤ 25 weeks. J Perinatol 45, 830–836 (2025). https://doi.org/10.1038/s41372-024-02206-9

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