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Lung ultrasound score and left ventricular eccentricity index in preterm infants with respiratory failure – a pilot study

Journal of Perinatology volume 46, pages 26–30 (2026)Cite this article

Subjects

Abstract

Objective

To investigate the association between lung ultrasound score (LUS) and left ventricular eccentricity index at end-systole (LVEI-s) and end-diastole (LVEI-d) in preterm infants with respiratory failure.

Study Design

This prospective pilot study included 38 ultrasounds on 20 premature infants with Transient Tachypnea of the Newborn (TTN) and Respiratory Distress Syndrome (RDS) requiring non-invasive ventilation at birth. LUS, LVEI-s, and LVEI-d were obtained daily for 72 h. Linear regression analysis was performed to determine correlation.

Results

LUS positively correlated with LVEI-s (r = 0.47, p = <0.01) and LVEI-d (r = 0.63, p = <0.01) during the 72-hour study period in the RDS group, but not the TTN group. Correlation increased over the first 24 h (LVEI-s: r = 0.69, p = <0.01; LVEI-d: r = 0.68, p = <0.01) in the RDS group.

Conclusion

As LUS increases, both LVEI-s and LVEI-d demonstrate measurable changes in infants with RDS. This association may enhance precision in diagnostic stratification and optimizing fluid management in neonatal lung disease.

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Fig. 1: Parasternal short-axis view of the left ventricle at the level of the papillary muscles obtained with point-of-care ultrasound.
Fig. 2: Correlation between LVEI and LUS in the RDS group.
Fig. 3: Comparing LVEI-s and LVEI-d over the first 24 h in the RDS and TTN groups.
Fig. 4: Lung disease severity diagnosed by LUS for all enrolled infants and LVEI. Mild (LUS 0-5), Moderate (LUS 6-10), and Severe disease (LUS > 10).

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Data availability

The data supporting these findings is not openly available but can be made available by the corresponding author upon request.

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Acknowledgements

We want to thank the University of Connecticut/Connecticut Children’s for supporting this research, the families agreeing to participate in the study, and the bedside nursing staff caring for the enrolled infants.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA

    Jacob Kelner, Naveed Hussain, Henry Chicaiza & Shalin Parekh

  2. Division of Neonatology, Connecticut Children’s, Hartford, CT, USA

    Jacob Kelner & Naveed Hussain

  3. Division of Pediatric Emergency Medicine, Connecticut Children’s, Hartford, CT, USA

    Henry Chicaiza

  4. Division of Cardiology, Connecticut Children’s, Hartford, CT, USA

    Shalin Parekh

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  1. Jacob Kelner
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Contributions

JK helped design the study, performed the ultrasounds, acquired the data for analysis, interpreted the data, and helped to write the manuscript. NH and HC helped design the study, interpret the results, and write the manuscript. SP helped design the study, interpret the results, ensure the quality of the ultrasound images, and write the manuscript.

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Correspondence to Jacob Kelner.

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Kelner, J., Hussain, N., Chicaiza, H. et al. Lung ultrasound score and left ventricular eccentricity index in preterm infants with respiratory failure – a pilot study. J Perinatol 46, 26–30 (2026). https://doi.org/10.1038/s41372-025-02429-4

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