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Lung Ultrasound (LUS) – RDS Score
Used mainly in neonates (especially preterm infants) to assess Respiratory Distress Syndrome (RDS) severity and guide respiratory management.
Purpose
Quantifies loss of lung aeration
Helps predict:
Need for surfactant
Need for mechanical ventilation
Disease severity and progression
Reduces reliance on chest X-ray
Lung Regions Examined
Most commonly:
6-zone method (most used in neonatology):
Right anterior, right lateral, right posterior
Left anterior, left lateral, left posterior
(Some protocols use 8 or 12 zones, but scoring principles are the same.)
Scoring System (per zone)
Each lung zone is scored 0–3 based on ultrasound pattern:
| Score | Ultrasound Pattern | Meaning |
|---|---|---|
| 0 | A-lines present, normal lung sliding | Normal aeration |
| 1 | ≥3 well-spaced B-lines | Mild interstitial syndrome |
| 2 | Coalescent B-lines (“white lung”) | Severe interstitial/alveolar disease |
| 3 | Lung consolidation ± air bronchograms | Complete loss of aeration |
Total LUS-RDS Score
Score per zone: 0–3
Total score (6 zones): 0–18
Interpretation (commonly used ranges)
| Total Score | Interpretation |
|---|---|
| 0–4 | Normal / minimal disease |
| 5–8 | Mild RDS |
| 9–13 | Moderate RDS |
| 14–18 | Severe RDS |
Clinical Correlations
Higher scores correlate with:
Lower oxygenation
Higher CPAP/ventilation needs
Increased likelihood of surfactant therapy
Many studies show LUS score ≥9–10 predicts surfactant requirement
Advantages
Bedside, radiation-free
Repeatable for monitoring response
High inter-observer reliability when trained
Limitations
Operator-dependent
Interpretation may overlap with:
Transient tachypnea of newborn (TTN)
Pneumonia
Pulmonary edema
If you want, I can:
Share a quick scoring diagram
Compare LUS vs chest X-ray
Explain cutoffs for surfactant decision-making
Adapt this to adult ARDS scoring
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