ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1638936
This article is part of the Research TopicPOCUS for Neonates: Advancing Care with Point-of-Care UltrasoundView all 5 articles
Neonatal Evaluation by eXtended (12 area) vs Traditional (6 area) Lung Ultrasound Scoring (NEXT-LUS): a prospective observational study.
Provisionally accepted
Chinmay Chetan1,2*
Shoham Majumder3
Aninda Debnath4Ravleen Kaur1,2Deepak Jaybhaye1,2Arshpuneet Kaur1,2
Saikat Patra1,2- 1Swami Rama Himalayan University, Dehradun, India
- 2Himalayan Institute of Medical Sciences, Dehradun, India
- 3All India Institute of Medical Sciences Kalyani, Kalyani, India
- 4Maulana Azad Medical College, New Delhi, India
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Lung ultrasound (LUS) offers a safe, repeatable, radiation-free tool in management of respiratory distress in neonates. Despite wide use, limited data exists on optimal scoring approaches.A prospective observational study was conducted over 6 months in a tertiary neonatal intensive care unit (NICU) enrolling neonates with respiratory distress within 2 hours of admission after consent. LUS was performed using both 6-area and 12-area scanning approaches. Scores were assigned per Brat's criteria. Primary outcome was prediction of need for invasive ventilation within 72 hours. Secondary outcomes included optimal cut-off scores, correlation with clinical outcomes and procedural safety. Results: Among 73 neonates enrolled, the 6-area LUS score (cut-off ≥5) predicted invasive mechanical ventilation within 72 hours with 75% sensitivity and 67% specificity (AUC = 0.76). The 12-area score (cut-off ≥13) had similar accuracy (sensitivity 75%, specificity 73%; AUC = 0.77). Both 6-area and 12-area scores performed better in neonates <34 weeks (AUCs: 0.83 vs. 0.86). In neonates presenting after 24 hours of life (n = 19), both scores maintained good accuracy (AUCs: 0.80 for 6-area, 0.83 for 12-area). Multivariate analysis identified partial pressure of carbon dioxide (pCO₂) and duration of stay as independent predictors. The 12-area score required reattempts (in 9% cases) unlike the 6-area score.In neonates presenting with respiratory distress, 6-area and 12-area LUS scores done within 2 hours of admission show good and comparable predictive value regarding need for invasive ventilation by 72 hours.
Keywords: preterm /full term infants, Neonat<sup>*</sup>, Lung, ultrasound, Respiratory distress, Invasive ventilation, Respiratory outcomes, PoCUS
Received: 31 May 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Chetan, Majumder, Debnath, Kaur, Jaybhaye, Kaur and Patra. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chinmay Chetan, Swami Rama Himalayan University, Dehradun, India
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