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CompletedNCT07809971Updated Sep 9, 2026

Predictive Value of Lung Ultrasound Combined With Serum ANGPL4 Levels for NICU Admission Needs in Late Preterm and Term Neonates With Respiratory Distress In The Transion Period

An observational study in Neonatal Respiratory Distress and Lung Ultrasound Score, sponsored by Tanta University. Completed at 1 site in Egypt. Open to participants aged Up to 2 Hours. Per ClinicalTrials.gov, last updated 2026-09-09.

Sponsored by Tanta University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
80
Ages
Up to 2 Hours
Sex
All
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Study summary

The aim of this study is to evaluate the validity of point-of-care lung ultrasound (POC-LUS) and serum ANGPL4 levels for predicting NICU admission needs in late preterm and full-term neonates with respiratory distress shortly after birth in the transition period.

Read the detailed description

Given its concordance with conventional x-ray, lung ultrasound (LU) has become an attractive diagnostic tool in neonatal settings, with its validation against a wide range of imaging techniques and excellent inter-observer agreement. LU is currently used for diagnosing several neonatal respiratory morbidities and has been proposed for predicting further interventions, such as the need for surfactant treatment or mechanical ventilation in preterm infants. The routine adoption of point-of-care LU in the NICU is still experiencing some limitations. However, the implementation of routine LU in the NICU would further optimize the management of newborns with, or at risk of, respiratory morbidities. Lung ultrasound alone may not be sufficient to fully assess the severity and prognosis of neonatal respiratory distress, so it is particularly important to explore the combined use of other biomarkers. In this area, angiopoietin-like protein 4 (ANGPTL4) has gradually attracted attention. ANGPTL4, first discovered in 2000 as a member of the angiopoietin-like protein subfamily, whose expression can be prominently induced under ischemic and hypoxic conditions, participating in various physiological effects, including lipid metabolism, wound healing, and vascular injury.Therefore, serum ANGPTL4 may be an underlying biomarker for the diagnosis and prognosis of neonatal respiratory distress syndrome

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Conditions studied

  • Neonatal Respiratory Distress
  • Lung Ultrasound Score

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Who can participate

Ages eligible
Up to 2 Hours
Sexes eligible
All
Sampling method
Non-probability sample

Study population

80 late preterm and term neonates with clinical evidence of respiratory distress soon after birth, at the NICU, Pediatrics Department, Tanta University Hospitals

Eligibility criteria

This study will include 80 late preterm and term neonates (≥34 gestional weeks) who will show any clinical signs of respiratory distress in the delivery room or within 30 minutes after birth.

The exclusion criteria:

  1. Preterm neonates with gestional age \<34 weeks.
  2. Neonates with antenatal diagnosis of congenital anomalies of the lungs or thoracic cage.
  3. Neonates with antenatal diagnosis of congenital heart disease.
  4. Neonates with antenatal diagnosis of other major congenital anomalies or chromsomal abnormality.
  5. Neonates born with severe perinatal asphyxia.
  6. Neonates born with severe apnea requiring intubation in the delitery room.
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
80 participants (actual)
Patient registry
No

Groups and cohorts

  • NICU admitted

    neonates admitted to the NICU

    Device: Point of care lung ultrasound (POC-LUS) · Diagnostic Test: Serum ANGPTL4

  • Non- admitted

    neonates not admitted to the NICU

    Device: Point of care lung ultrasound (POC-LUS) · Diagnostic Test: Serum ANGPTL4

Interventions

  • DevicePoint of care lung ultrasound (POC-LUS)

    It will be done whithin 2 hours after birth in the transition nursery area and will be recorded as per-validated LUS scoring system: each lung will be divided into 3 areas (upper anterior, lower anterior and lateral). For each lung area, a 0-3 point score will be given. The total score would be 0-18. A maximum score of 18 is the top denomination score for this study.

  • Diagnostic testSerum ANGPTL4

    Samples will be withdrawn wthin the first 2 hours after birth, just after finishing the POC-LUS evaluation

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What researchers measure

Primary outcomes

  1. NICU admission

    Need for NICU admission among late-preterm and term neonates presenting with respiratory distress during the early transitional period after birth. The decision for NICU admission will be made independently by the treating clinical team according to clinical criteria and standards of care, blinded to the research measurements of lung ultrasound score and serum ANGPTL4 level.

    Time frame: Within the first 2 hours after birth

Secondary outcomes

  1. Duration of respiratory support

    Time needed on respiratory support in days

    Time frame: From NICU admission till discontinuation of respiratory support up to 14 days

  2. Length of NICU stay

    Number of days from NICU admission until discharge or death

    Time frame: From NICU admission until discharge or death up to 21 days

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Study locations

1 site
  • faculty of medicine,Tanta University
    Tanta, Q2x2+cp Tanta 2, Egypt 31527, Egypt
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References and documents

Publications

  • Stark AR. Levels of neonatal care. Pediatrics. 2004;114(5):1341-1347. 2. Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Every Newborn: progress, priorities, and potential beyond survival. Lancet. 2014;384(9938):189-205. 3. Martin RJ, Fanaroff AA, Walsh MC. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia: Elsevier; 2019. 4. Hermansen CL, Lorah KN. Respiratory distress in the newborn. Am Fam Physician. 2007;76(7):987-94. 5. Dani C, Corsini I, Poggi C. Pneumothorax in the newborn: What to do? J Matern Fetal Neonatal Med. 2021;34(21):3548-3554. 6. Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 update. Neonatology. 2019;115(4):432-450. 7. Liu J, Wang Y, Fu W, Yang Q, Zhang Q, Feng Z, et al. Diagnosis of neonatal respiratory distress using lung ultrasound. Medicine (Baltimore). 2014;93(27):e275. 8. Cloherty JP, Eichenwald EC, Hansen AR. Manual of Neonatal Care. 8th ed. Philadelphia: Wolters Kluwer; 2017. 9. Zanardo V, Simbi AK, Franzoi M, Soldà G, Salvadori A, Trevisanuto D. Neonatal respiratory morbidity risk and mode of delivery at term: Influence of timing of elective caesarean delivery. Acta Paediatr. 2004;93(5):643-647. 10. Stogianni A, Liosi M, Drossou V, Pliarchopoulou F, Nika H, Panagopoulos G. Neonatal outcomes in pregnancies complicated by diabetes. J Neonatal Perinatal Med. 2020;13(1):73-78. 11. Levine EM, Ghai V, Barton JJ, Strom CM. Mode of delivery and risk of respiratory diseases in newborns. Obstet Gynecol. 2001;97(3):439-442.
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Registry details

Key details

Study ID
NCT07809971
Lead sponsor
Tanta University
Responsible party
Lamiaa Khaled Zidan (Lecturer of Pediatrics, Faculty of Medicine, Tanta University, Tanta University) — Principal investigator
First posted
Sep 9, 2026
Start date
Aug 1, 2025
Primary completion
Aug 31, 2026
Completion
Aug 31, 2026
Last update
Sep 9, 2026

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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