Integrated Echocardiography and Chest Ultrasound Assessment of Lung Recruitment in Preterm Infants

Condition(s) studied

Investigational drug(s) / intervention(s)

Lung recruitment: establishment of lung recruitment using high frequency ventilation and assessment with chest ultrasound and echocardiography

Study summary

The primary aim of this work is to evaluate the role of high frequency oscillatory ventilation (HFOV) in recruitment of lung in preterm newborns 32 to 37 weeks gestational age with moderate to severe respiratory distress. The secondary aim is to evaluate the role of chest ultrasound in monitoring of lung recruitment in comparison to routine chest x ray in those babies. Also cardiac hemodynamics will be assesed using functional echocardiography.

Eligibility

Primary outcome measure(s)

• chest US — first 3 days after birth
  A mobile device (PHILIPS ® HD11 XE) with a 10-MHz linear probe will be used for chest ultrasound the 12 lung zones will be assessed regarding 1. presence Of A lines, B-lines or C-profile 2. presence or absence of pleural sliding
• Superior Vena Cava flow in ml/kg/min — first 3 days of life
  Superior Vena Cava (SVC) Blood Flow using functional echocardiography
• estimated pulmonary artery pressure in mmHg — first 3 days of life
  Pulmonary artery pressure (PAP) will be assessed by measuring tricuspid valve regurgitation peak velocity: this will be measured in apical 4 chamber view, with continous wave Doppler using modified Bernoulli equation. Systolic pulmonary artery pressure is equivalent to right ventricular systolic pressure in absence of outflow obstruction. Systolic Pulmonary Artery Pressure (SPAP) = Right Ventricular Systolic Pressure = 4x TR2 + Right Atrial Pressure (RAP), with RAP= 3-5 mmHg.

Trial sites (2)

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