Diagnostic Utility of Bedside “Point of Care Lung Ultrasound” in Predicting the Need For NICU Admission in Late Preterm and Term Newborns Having Respiratory Distress Soon After Birth in the Transition Period: A Prospective Observational Study

ABSTRACT Background Point of care lung ultrasound (POC‐LUS) is a rapid and simple method to evaluate infants with respiratory distress after birth. Objectives The primary objective was to determine whether the POC‐LUS score is a good predictor of NICU admission in late preterm and term infants born with respiratory distress when performed within the first 2 h of life. The secondary objective was to find a correlation between the LUS score and the clinical respiratory distress severity score. Methods A prospective observational study was carried out in a tertiary care neonatal unit (Level III) over 1 year on 97 late preterm and term infants having respiratory distress at birth. POC‐LUS was performed in a transition nursery area within 2 h of birth, and LUS score was recorded as per a pre‐validated LUS scoring system. The decision for NICU admission was independently taken by the medical team based on clinical criteria and blinded to the LUS findings. A receiver operating characteristic (ROC) curve was generated to predict NICU admission based on the LUS score. LUS score was also analyzed for correlation with clinical respiratory distress severity scoring, that is, Silverman−Anderson score (SA score). Results The mean gestational age of the infants in the study was 37.45 ± 1.88 weeks. Fourty‐three percent of infants needed NICU admission. LUS score > 5/18 performed within 2 h after birth was an excellent predictor of NICU admission in late preterm and term infants with respiratory distress after birth (area under ROC curve 0.903, sensitivity 64%, specificity 98%, positive likelihood ratio 35, and p < 0.001). LUS score also had a weak positive correlation with the SA score (Pearson's correlation, r = 0.325; p = 0.001). Conclusion A LUS score of > 5/18 is an excellent predictor of NICU admission in term and late‐preterm infants with respiratory distress after birth.