The Value Of Lung Ultrasound Score On Evaluating Clinical Severity And Prognosis In Patients With Neonatal Infectious Pneumonia

Objective: To evaluate the value of lung ultrasound score on assessing the clinical severity and prognosis in neonates with infectious pneumonia, and study the correlation between lung ultrasound score and traditional parameters, such as oxygenation index 、 respiratory index 、neonatal critical illness score.Methods: In this study,98 cases of neonates with infectious pneumonia in Hunan Children Hospital’s neonatal admitted to hospital,from March 2015 to November 2015, the lung ultrasound score and the clinical data of neonates were analyzed.(1) According to whether merger of respiratory failure, the neonates were divided into the respiratory failure and non-respiratory failure group then compare with the lung ultrasound score of two groups. Receiver operator characteristic curve(ROC) was plotted, and the predictive value, sensitivity and specificity of respiratory failure by lung ultrasound score were calculated.(2)According to the neonatal critical illness score, the respiratory failure neonates were divided into non-critical, critical and extremely criticalgroup,and then compare with the lung ultrasound score of there groups.ROC was plotted, and the predictive value, sensitivity and specificity of critical or extremely critical by lung ultrasound score were calculated.(3)The correlation between lung ultrasound score and oxygenation index as well as respiratory index, the neonatal critical illness score was analyzed by bivariate correlation analysis.(4) According to the prognosis, the respiratory failure neonates were divided into death and survival group,then compare two groups’ lung ultrasound score. ROC was plotted, and the predictive value, sensitivity and specificity of mortality by lung ultrasound score were calculated.Result:(1) Lung ultrasound score of respiratory failure group is23.12±7.03, lung ultrasound score of non-respiratory failure group is34.61±5.36. Lung ultrasound score was statistical difference between the two groups(P<0.01). The predictive value for respiratory failure by lung ultrasound score was 31, sensitivity of 84.6%, specificity of 76.1%.(2)Lung ultrasound score of non-critical respiratory failure is 28.50±2.21,lung ultrasound score of critical is 23.84±3.35,lung ultrasound score of very-critical is 15.89±2.32.Lung ultrasound score was statistical difference among the there groups(P<0.01). The predictive value for critical neonates by lung ultrasound score was 27, sensitivity of 81.6%,specificity of 85.7%. The predictive value for critical neonates by lung ultrasound score was 17, sensitivity of 76.9%, specificity of 92.0%.(3)Lung ultrasound score was positively correlated with the oxygenation index(r=0.831,P<0.01), was negatively correlated with respiratory index(r=-0.819,P<0.01),was positively correlated with the neonatal critical illness score(r=0.887,P<0.01).(4) Lung ultrasound score of death group is 14.73±2.80,and lung ultrasound score of survival group is25.37±6.04.The neonates with lung ultrasound score<18 had a high mortality, sensitivity of 88.6%, specificity of 82.9%.Conclusion: There is a correlation of lung ultrasound score and the clinical severity and prognosis of infectious pneumonia. The disease is more severity, lung ultrasound score is lower, the prognosis of infectious pneumonia is worse, the mortality is higher.