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VOLUME 2 , ISSUE 1 ( January-March, 2023 ) > List of Articles


Lung Ultrasound in Neonates: An Emerging Tool for Monitoring Critically Ill Infants

Arjun Verma, Abhishek Paul, Atnafu Mekonnen Tekleab, Abhay Lodha, Jan Klimek, Pradeep Suryawanshi

Keywords : Bronchopulmonary dysplasia, Conventional lung ultrasound score, Modified lung ultrasound score, Pneumothorax, Point-of-care lung ultrasound, Respiratory distress syndrome, Transient tachypnea of newborn

Citation Information : Verma A, Paul A, Tekleab AM, Lodha A, Klimek J, Suryawanshi P. Lung Ultrasound in Neonates: An Emerging Tool for Monitoring Critically Ill Infants. 2023; 2 (1):80-90.

DOI: 10.5005/jp-journals-11002-0057

License: CC BY-NC 4.0

Published Online: 07-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Context: Neonatal lung ultrasound is emerging as a useful clinical tool for the assessment of lung anatomy and management of various lung pathologies. In this review, we summarize normal lung ultrasound (LUS) findings and specific features of various lung morbidities. Evidence acquisition: A comprehensive literature search was conducted across multiple sources with relevant keywords with an additional filter of the age-group between 0 and 28 days. Findings: Apart from the description of normal newborn lungs, clinical and radiological features of a variety of lung pathologies were evaluated and incorporated in the review. Bedside LUS has evolved to be an important point-of-care imaging modality that can help in day-to-day clinical decision-making. It can be used in differentiating respiratory distress syndrome from transient tachypnea on the newborns, in the detection of pneumothorax, and in diagnosing pneumonia, pulmonary hemorrhage, and pleural effusion. Evidence supports the use of LUS scores to decide on the need for early rescue surfactant therapy with high sensitivity and specificity. Lung ultrasound scores obtained during the first 2 weeks after birth can help predict the likelihood of chronic lung disease/bronchopulmonary dysplasia. Once validated, it could be valuable for guiding early intervention and evaluation of new treatments. Conclusion: Neonatal lung ultrasound is emerging as a vital monitoring tool in critically ill infants with lung disease. It will be valuable in the early diagnosis, management, and prognosis of these patients.

  1. Raimondi F, Yousef N, Migliaro F, et al. Point-of-care lung ultrasound in neonatology: Classification into descriptive and functional applications. Pediatr Res 2021;90(3):524–531. DOI: 10.1038/s41390-018-0114-9.
  2. Kurepa D, Zaghloul N, Watkins L, et al. Neonatal lung ultrasound exam guidelines. J Perinatol 2018;38(1):11–22. DOI: 10.1038/jp.2017.140.
  3. Cattarossi L. Lung ultrasound: Its role in neonatology and pediatrics. Early Hum Dev 2013;89(Suppl 1):S17–S19. DOI: 10.1016/S0378-3782(13)70006-9.
  4. Chen SW, Fu W, Liu J, et al. Routine application of lung ultrasonography in the neonatal intensive care unit. Medicine (Baltimore) 2017;96(2):e5826. DOI: 10.1097/MD.0000000000005826.
  5. Ibrahim M, Omran A, AbdAllah NB, et al. Lung ultrasound in early diagnosis of neonatal transient tachypnea and its differentiation from other causes of neonatal respiratory distress. J Neonatal Perinatal Med 2018;11(3):281–287. DOI: 10.3233/NPM-181796.
  6. Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 2012;38(4):577–5791. DOI: 10.1007/s00134-012-2513-4.
  7. Miller A. Practical approach to lung ultrasound. BJA Education 2016;16(2):39–45. DOI: 10.1093/bjaceaccp/mkv012.
  8. Rath C, Suryawanshi P. Point of care neonatal ultrasound – Head, lung, gut and line localization. Indian Pediatr 2016;53(10):889–899. DOI: 10.1007/s13312-016-0954-5.
  9. Abu-Zidan FM, Hefny AF, Corr P. Clinical ultrasound physics. J Emerg Trauma Shock 2011;4(4):501–503. DOI: 10.4103/0974-2700.86646.
  10. Carovac A, Smajlovic F, Junuzovic D. Application of ultrasound in medicine. Acta Inform Med Sep 2011;19(3):168–171. DOI: 10.5455/aim.2011.19.168-171.
  11. O'Brien WD, Ultrasound-biophysics mechanisms. Prog Biophys Mol Biol 2007;93(1–3):212–255. DOI: 10.1016/j.pbiomolbio.2006.07.010.
  12. Iovine E, Nenna R, Bloise S, et al. Lung ultrasound: Its findings and new applications in neonatology and pediatric diseases. Diagnostics 2021;11(4):652. DOI: 10.3390/diagnostics11040652.
  13. Pryor EJ, Kitchen MJ, Croughan MK, et al. Improving lung aeration in ventilated newborn preterm rabbits with a partially aerated lung. J Appl Physiol (1985) 2020;129(4):891–900. DOI: 10.1152/japplphysiol.00426.2020.
  14. Dahmarde H, Parooie F, Salarzaei M. Accuracy of ultrasound in diagnosis of pneumothorax: A comparison between neonates and adults-A systematic review and meta-Analysis. Can Respir J 2019;2019:5271982. DOI: 10.1155/2019/5271982.
  15. Reuter S, Moser C, Baack M. Respiratory distress in the newborn. Pediatr Rev 2014;35(10):417–428. DOI: 10.1542/pir.35-10-417.
  16. Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest 1995;108(5): 1345–1348. DOI: 10.1378/chest.108.5.1345.
  17. Bober K, Swietlinski J. Diagnostic utility of ultrasonography for respiratory distress syndrome in neonates. Med Sci Monit 2006;12(10):CR440–CR446. PMID: 17006405.
  18. Liu J, Liu F, Liu Y, et al. Lung ultrasonography for the diagnosis of severe neonatal pneumonia. Chest 2014;146(2):383–388. DOI: 10.1378/chest.13-2852.
  19. Nakos G, Tsangaris H, Liokatis S, et al. Ventilator-associated pneumonia and atelectasis: Evaluation through bronchoalveolar lavage fluid analysis. Intensive Care Med 2003;29(4):555–563. DOI: 10.1007/s00134-003-1680-8.
  20. Reissig A, Gramegna A, Aliberti S. The role of lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia. Eur J Intern Med 2012;23(5):391–397. DOI: 10.1016/j.ejim.2012.01.003.
  21. Avni EF, Braude P, Pardou A, et al. Hyaline membrane disease in the newborn: Diagnosis by ultrasound. Pediatr Radiol 1990;20(3):143–146. DOI: 10.1007/BF02012957.
  22. Hew M, Tay TR. The efficacy of bedside chest ultrasound: From accuracy to outcomes. Eur Respir Rev 2016;25(141):230–246. DOI: 10.1183/16000617.0047-2016.
  23. Liu X, Si S, Guo Y, et al. Limitations of bedside lung ultrasound in neonatal lung diseases. Front Pediatr 2022;10:855958. DOI: 10.3389/fped.2022.855958.
  24. Amatya Y, Rupp J, Russell FM, et al. Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting. Int J Emerg Med 2018;11(1):8. DOI: 10.1186/s12245-018-0170-2.
  25. Saraogi A. Lung ultrasound: Present and future. Lung India 2015;32(3):250–257. DOI: 10.4103/0970-2113.156245.
  26. Escourrou G, De Luca D. Lung ultrasound decreased radiation exposure in preterm infants in a neonatal intensive care unit. Acta Paediatr 2016;105(5):e237–e239. DOI: 10.1111/apa.1336918.
  27. Gislason-Lee AJ. Patient X-ray exposure and ALARA in the neonatal intensive care unit: Global patterns. Pediatr Neonatol 2021;62(1):3–10. DOI: 10.1016/j.pedneo.2020.10.009.
  28. Marini TJ, Rubens DJ, Zhao YT, et al. Lung ultrasound: The essentials. Radiol Cardiothorac Imaging 2021;3(2):e200564. DOI: 10.1148/ryct.2021200564.
  29. Lee J. Lung ultrasound as a monitoring tool. Tuberc Respir Dis 2020;83(Suppl 1):S12–S16. DOI: 10.4046/trd.2020.0149.
  30. Fernandez LR, Hernandez RG, Guerediaga IS, et al. Usefulness of lung ultrasound in the diagnosis and follow-up of respiratory diseases in neonates. An Pediatr (Engl Ed) 2022;96(3):252e1–252e13. DOI: 10.1016/j.anpede.2022.01.002.
  31. Liang HY, Liang XW, Chen ZY, et al. Ultrasound in neonatal lung disease. Quant Imaging Med Surg 2018;8(5):535–546. DOI: 10.21037/qims.2018.06.01.
  32. Ammirabile A, Buonsenso D, Di Mauro A. Lung ultrasound in pediatrics and neonatology: An update. Healthcare (Basel) 2021;9(8):1015. DOI: 10.3390/healthcare9081015.
  33. Tusman G, Acosta CM, Costantini M. Ultrasonography for the assessment of lung recruitment maneuvers. Crit Ultrasound J 2016;8(1):8. DOI: 10.1186/s13089-016-0045-9.
  34. Chioma R, Amabili L, Ciarmoli E, et al. Lung ultrasound targeted recruitment (LUSTR): A novel protocol to optimize open lung ventilation in critically Ill neonates. Children (Basel) 2022;9(7):1035. DOI: 10.3390/children9071035.
  35. Mor Conejo M, Guitart Pardellans C, Fresan Ruiz E, et al. Lung recruitment maneuvers assessment by bedside lung ultrasound in pediatric acute respiratory distress syndrome. Children (Basel) 2022;9(6):789. DOI: 10.3390/children9060789.
  36. Werther T, Kueng E, Aichhorn L, et al. Regular lung recruitment maneuvers during high-frequency oscillatory ventilation in extremely preterm infants: A randomized controlled trial. BMC Pediatr 2022;22(1):710. DOI: 10.1186/s12887-022-03780-7.
  37. Zong H, Huang Z, Zhao J, et al. The value of lung ultrasound score in neonatology. Front Pediatr 2022;10:791664. DOI: 10.3389/fped.2022.791664.
  38. Poerio A, Galletti S, Baldazzi M, et al. Lung ultrasound features predict admission to the neonatal intensive care unit in infants with transient neonatal tachypnoea or respiratory distress syndrome born by caesarean section. Eur J Pediatr 2021;180(3):869–876. DOI: 10.1007/s00431-020-03789-z.
  39. Liu JMP, Cao HYM, Wang HWM, et al. The role of lung ultrasound in diagnosis of respiratory distress syndrome in newborn infants. Iran J Pediatr 2014;24(2):147–154. PMID: 25535532.
  40. Bhoil R, Ahluwalia A, Chopra R, et al. Signs and lines in lung ultrasound. J Ultrason 2021;21(86):e225–e233. DOI: 10.15557/JoU.2021.0036.
  41. Rea G, Sperandeo M, Di Serafino M, et al. Neonatal and pediatric thoracic ultrasonography. J Ultrasound 2019;22(2):121–130. DOI: 10.1007/s40477-019-00357-6.
  42. Ostras O, Soulioti DE, Pinton G. Diagnostic ultrasound imaging of the lung: A simulation approach based on propagation and reverberation in the human body. J Acoust Soc Am. 2021;150(5):3904. DOI: 10.1121/10.0007273.
  43. Lichtenstein DA, Mauriat P. Lung ultrasound in the critically Ill neonate. Curr Pediatr Rev 2012;8(3):217–223. DOI: 10.2174/157339612802139389.
  44. Di Serafino M, Notaro M, Rea G, et al. The lung ultrasound: Facts or artifacts? In the era of COVID-19 outbreak. Radiol Med 2020;125(8):738–753. DOI: 10.1007/s11547-020-01236-5.
  45. Thakur A, Fursule A. Lung ultrasound in neonates – An underused tool. J Med Imaging Radiat Oncol 2022;67(1):54–64. DOI: 10.1111/1754-9485.13485.
  46. Ibarra-Rios D, Enriquez-Estrada AC, Serpa-Maldonado EV, et al. Lung ultrasound characteristics in neonates with positive real time polymerase chain reaction for SARS-CoV-2 on a tertiary level referral hospital in Mexico city. Front Pediatr 2022;10:859092. DOI: 10.3389/fped.2022.859092.
  47. Copetti R, Cattarossi L. The ‘double lung point’: An ultrasound sign diagnostic of transient tachypnea of the newborn. Neonatology 2007;91(3):203–209. DOI: 10.1159/000097454.
  48. Dietrich CF, Mathis G, Blaivas M, et al. Lung B-line artefacts and their use. J Thorac Dis 2016;8(6):1356–1365. DOI: 10.21037/jtd.2016.04.55.
  49. Li S, Zhang QL, Guo RJ, et al. Quantitative evaluation and significance of ultrasound in bronchoalveolar lavage for lung consolidation in children with severe mycoplasma pneumonia. Transl Pediatr 2021;10(9):2325–2334. DOI: 10.21037/tp-21-381.
  50. Tardella M, Di Carlo M, Carotti M, et al. Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis: Cut-off point definition for the presence of significant pulmonary fibrosis. Medicine (Baltimore) 2018;97(18):e0566. DOI: 10.1097/MD.0000000000010566.
  51. Wang J, Wei H, Chen H, et al. Application of ultrasonography in neonatal lung disease: An updated review. Front Pediatr 2022;10:1020437. DOI: 10.3389/fped.2022.1020437.
  52. Liszewski MC, Lee EY. Neonatal lung disorders: Pattern recognition approach to diagnosis. AJR am J Roentgenol 2018;210(5):964–975. DOI: 10.2214/AJR.17.19231.
  53. Lee FC. Lung ultrasound-a primary survey of the acutely dyspneic patient. J Intensive Care 2016;4(1):57. DOI: 10.1186/s40560-016-0180-1.
  54. Grune J, Beyhoff N, Hegemann N, et al. From bedside to bench: Lung ultrasound for the assessment of pulmonary edema in animal models. Cell Tissue Res 2020;380(2):379–392. DOI: 10.1007/s00441-020-03172-2.
  55. Jain SN, Modi T, Varma RU. Decoding the neonatal chest radiograph: An insight into neonatal respiratory distress. Indian J Radiol Imaging 2020;30(4):482–492. DOI: 10.4103/ijri.IJRI_281_20.
  56. Stadler JAM, Andronikou S, Zar HJ. Lung ultrasound for the diagnosis of community-acquired pneumonia in children. Pediatr Radiol 2017;47(11):1412–1419. DOI: 10.1007/s00247-017-3910-1.
  57. Guo BB, Pang L, Yang B, et al. Lung ultrasound for the diagnosis and management of neonatal respiratory distress syndrome: A minireview. Front Pediatr 2022;10:864911. DOI: 10.3389/fped.2022.864911.
  58. Husain LF, Hagopian L, Wayman D, et al. Sonographic diagnosis of pneumothorax. J Emerg Trauma Shock Jan 2012;5(1):76–81. DOI: 10.4103/0974-2700.93116.
  59. Liu J, Copetti R, Sorantin E, et al. Protocol and guidelines for point-of-care lung ultrasound in diagnosing neonatal pulmonary diseases based on international expert consensus. J Vis Exp 2019;(145). DOI: 10.3791/58990.
  60. Hamadah HK, Kabbani MS. Bedside ultrasound in the diagnosis and treatment of children with respiratory difficulty following cardiac surgery. J Clin Imaging Sci 2017;7:37. DOI: 10.4103/jcis.JCIS_42_17.
  61. Basha MI, Kaur R, Chawla D, et al. Evaluation of double lung point sign as a marker for transient tachypnoea of the newborn in preterm. Pol J Radiol 2022;87:e220–e225. DOI: 10.5114/pjr.2022.115719.
  62. Sefic Pasic I, Riera Soler L, Vazquez Mendez E, et al. Comparison between lung ultrasonography and chest X-ray in the evaluation of neonatal respiratory distress syndrome. J Ultrasound 2022. DOI: 10.1007/s40477-022-00728-6.
  63. Liu J, Cao HY, Wang HW, et al. The role of lung ultrasound in diagnosis of respiratory distress syndrome in newborn infants. Iran J Pediatr 2015;25(1):e323. DOI: 10.5812/ijp.323.
  64. Vergine M, Copetti R, Brusa G, et al. Lung ultrasound accuracy in respiratory distress syndrome and transient tachypnea of the newborn. Neonatology 2014;106(2):87–93. DOI:10.1159/000358227.
  65. Deng B, Xu F, Li J, et al. Case Report: Lung ultrasound in critically ill neonates with lung diseases: Experience from several typical cases. Front Pediatr 2022;10:846279.18. DOI: 10.3389/fped.2022.846279.
  66. Touw HR, Parlevliet KL, Beerepoot M, et al. Lung ultrasound compared with chest X-ray in diagnosing postoperative pulmonary complications following cardiothoracic surgery: A prospective observational study. Anaesthesia 2018;73(8):946–954. DOI: 10.1111/anae.14243.
  67. Rodriguez-Fanjul J, Jordan I, Balaguer M, et al. Early surfactant replacement guided by lung ultrasound in preterm newborns with RDS: The ULTRASURF randomised controlled trial. Eur J Pediatr 2020;179(12):1913–1920. DOI: 10.1007/s00431-020-03744-y.
  68. Razak A, Faden M. Neonatal lung ultrasonography to evaluate need for surfactant or mechanical ventilation: A systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 2020;105(2):164–171. DOI: 10.1136/archdischild-2019-316832.
  69. Brat R, Yousef N, Klifa R, et al. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr 2015;169(8):e151797. DOI: 10.1001/jamapediatrics.2015.1797.
  70. Raschetti R, Yousef N, Vigo G, et al. Echography-Guided surfactant therapy to improve timeliness of surfactant replacement: A quality improvement project. J Pediatr 2019;212:137e1–143 e1. DOI: 10.1016/j.jpeds.2019.04.020.
  71. Srinivasan S, Aggarwal N, Makhaik S, et al. Role of lung ultrasound in diagnosing and differentiating transient tachypnea of the newborn and respiratory distress syndrome in preterm neonates. J Ultrason 2022;22(88):e1–e5. DOI: 10.15557/JoU.2022.0001.
  72. Liu J, Chen XX, Li XW, et al. Lung ultrasonography to diagnose transient tachypnea of the newborn. Chest 2016;149(5):1269–1275. DOI: 10.1016/j.chest.2015.12.024.
  73. Liu J, Wang Y, Fu W, et al. Diagnosis of neonatal transient tachypnea and its differentiation from respiratory distress syndrome using lung ultrasound. Medicine (Baltimore) 2014;93(27):e197. DOI: 10.1097/MD.0000000000000197.
  74. He L, Sun Y, Sheng W, et al. Diagnostic performance of lung ultrasound for transient tachypnea of the newborn: A meta-analysis. PLoS One 2021;16(3):e0248827. DOI: 10.1371/journal.pone.024882747.
  75. Liang LD, Kotadia N, English L, et al. Predictors of mortality in neonates and infants hospitalized with sepsis or serious infections in developing countries: A systematic review. Front Pediatr. 2018;6:277. DOI: 10.3389/fped.2018.00277.
  76. Ramasethu J. Prevention and treatment of neonatal nosocomial infections. Matern Health Neonatol Perinatol 2017;3:5. DOI: 10.1186/s40748-017-0043-3.
  77. Bhatta DR, Hosuru Subramanya S, Hamal D, et al. Bacterial contamination of neonatal intensive care units: How safe are the neonates? Antimicrob Resist Infect Control 2021;10(1):26. DOI: 10.1186/s13756-021-00901-2.
  78. Ben Jaballah N, Bouziri A, Kchaou W, et al. Epidemiology of nosocomial bacterial infections in a neonatal and pediatric Tunisian intensive care unit. Med Mal Infect 2006;36(7):379–385. DOI: 10.1016/j.medmal.2006.05.004.
  79. Naderi-Nasab M, Farhat A, Tajzadeh P, et al. Study of the bacterial agents in nosocomial and acquired infections based on the blood culture in neonatal intensive care unit of a hospital, northeast of Iran. Saudi Med J 2007;28(5):723–726. PMID: 17457439.
  80. Kumar S, Shankar B, Arya S, et al. Healthcare associated infections in neonatal intensive care unit and its correlation with environmental surveillance. J Infect Public Health 2018;11(2):275–279. DOI: 10.1016/j.jiph.2017.08.005.
  81. Fink AZ, Levin TL, Blumfield E, et al. Discrepancies in radiograph interpretation between pediatric radiologists and pediatric intensivists in the pediatric or neonatal intensive care unit. J Am Coll Radiol 2018;15(11):1580–1586. DOI: 10.1016/j.jacr.2017.12.00718.
  82. Elemraid MA, Muller M, Spencer DA, et al. Accuracy of the interpretation of chest radiographs for the diagnosis of paediatric pneumonia. PLoS One 2014;9(8):e106051. DOI: 10.1371/journal.pone.0106051.
  83. Garin N, Marti C, Scheffler M, et al. Computed tomography scan contribution to the diagnosis of community-acquired pneumonia. Curr Opin Pulm Med 2019;25(3):242–248. DOI: 10.1097/MCP.0000000000000567.
  84. Tsou PY, Chen KP, Wang YH, et al. Diagnostic accuracy of lung ultrasound performed by novice vs advanced sonographers for pneumonia in children: A systematic review and meta-analysis. Acad Emerg Med 2019;26(9):1074–1088. DOI: 10.1111/acem.13818.
  85. Inchingolo R, Copetti R, Smargiassi A, et al. Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population. J Ultrasound 2021;24(2):191–200. DOI: 10.1007/s40477-020-00547-7.
  86. Lacedonia D, Quarato CMI, Borelli C, et al. Transthoracic ultrasound in infectious organizing pneumonia: A useful guide for percutaneous needle biopsy. Front Med (Lausanne) 2021;8:708937. DOI:10.3389/fmed.2021.708937.
  87. Sartori S, Tombesi P. Emerging roles for transthoracic ultrasonography in pulmonary diseases. World J Radiol 2010;2(6):203–214. DOI: 10.4329/wjr.v2.i6.203.
  88. Hiles M, Culpan AM, Watts C, et al. Neonatal respiratory distress syndrome: Chest X-ray or lung ultrasound? A systematic review. Ultrasound 2017;25(2):80–91. DOI: 10.1177/1742271X16689374.
  89. Kharasch S, Duggan NM, Cohen AR, et al. Lung ultrasound in children with respiratory tract infections: Viral, bacterial or COVID-19? A narrative review. Open Access Emerg Med. 2020;12:275–285. DOI: 10.2147/OAEM.S238702.
  90. Bouhemad B, Zhang M, Lu Q, et al. Clinical review: Bedside lung ultrasound in critical care practice. Crit Care 2007;11(1):205. DOI: 10.1186/cc5668.
  91. Gillman LM, Panebianco N, Alkadi A, et al. The dynamic sonographic air bronchogram: A simple and immediate bedside diagnosis of alveolar consolidation in severe respiratory failure. J Trauma 2011;70(3):760. DOI: 10.1097/TA.0b013e3181ac8f82.
  92. Lichtenstein D, Meziere G, Seitz J. The dynamic air bronchogram. A lung ultrasound sign of alveolar consolidation ruling out atelectasis. Chest 2009;135(6):1421–1425. DOI: 10.1378/chest.08-2281.
  93. Shah A, Oliva C, Stem C, et al. Application of dynamic air bronchograms on lung ultrasound to diagnose pneumonia in undifferentiated respiratory distress. Respir Med Case Rep 2022;39:101706. DOI: 10.1016/j.rmcr.2022.10170694.
  94. Lichtenstein DA, Lascols N, Prin S, et al. The “lung pulse”: An early ultrasound sign of complete atelectasis. Intensive Care Med 2003;29(12):2187–2192. DOI: 10.1007/s00134-003-1930-9.
  95. Jesús David GB, Jose Dario OG, Eduard Orlando VP, et al. Pulmonary ultrasound vs radiography as a diagnostic method of pneumonia in pediatric patients. J Biomed Sci 2022;4(6):OAJBS.ID.000521. DOI: 10.38125/OAJBS.000521.
  96. Karkhanis VS, Joshi JM. Pleural effusion: Diagnosis, treatment, and management. Open Access Emerg Med 2012;4:31–52. DOI: 10.2147/OAEM.S29942.
  97. Mohamed MFH, Al-Shokri S, Yousaf Z, et al. Frequency of abnormalities detected by point-of-care lung ultrasound in symptomatic COVID-19 patients: Systematic review and meta-analysis. Am J Trop Med Hyg 2020;103(2):815–821. DOI: 10.4269/ajtmh.20-0371.
  98. Rizvi MB, Rabiner JE. Pediatric point-of-care lung ultrasonography: A narrative review. West J Emerg Med 2022;23(4):497–504. DOI: 10.5811/westjem.2022.3.54663.
  99. Dominguez MC, Alvares BR. Pulmonary atelectasis in newborns with clinically treatable diseases who are on mechanical ventilation: Clinical and radiological aspects. Radiol Bras 2018;51(1):20–25. DOI: 10.1590/0100-3984.2016.0157.
  100. Chakkarapani AA, Adappa R, Mohammad Ali SK, et al. “Current concepts of mechanical ventilation in neonates” – Part 1: Basics. Int J Pediatr Adolesc Med 2020;7(1):13–18. DOI: 10.1016/j.ijpam.2020.03.003.
  101. Grott K, Chauhan S, Dunlap JD. Atelectasis. [Updated 2022 Oct 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:
  102. Gargani L. Lung ultrasound: A new tool for the cardiologist. Cardiovasc Ultrasound 2011;9:6. DOI: 10.1186/1476-7120-9-6.
  103. Bossuyt PM, Reitsma JB, Bruns DE, et al. STARD 2015: An updated list of essential items for reporting diagnostic accuracy studies. BMJ 2015;351:h5527. DOI: 10.1136/bmj.h5527.
  104. Oktem A, Yigit S, Oguz B, et al. Accuracy of lung ultrasonography in the diagnosis of respiratory distress syndrome in newborns. J Matern Fetal Neonatal Med 2021;34(2):281–286. DOI: 10.1080/14767058.2019.1605350.
  105. Liu J, Chen S, Liu F, et al. BPD, Not BPD, or iatrogenic BPD: Findings of lung ultrasound examinations. Medicine (Baltimore) 2014;93:e133. DOI: 10.1097/MD.0000000000000133.
  106. Chichra A, Makaryus M, Chaudhri P, et al. Ultrasound for the pulmonary consultant. Clin Med Insights Circ Respir Pulm Med 2016;10:1–9. DOI: 10.4137/CCRPM.S33382.
  107. Chen SW, Zhang MY, Liu J. Application of lung ultrasonography in the diagnosis of childhood lung diseases. Chin Med J (Engl) 2015;128(19):2672–2678. DOI: 10.4103/0366-6999.166035.
  108. Shalish W, Kanbar L, Kovacs L, et al. Assessment of extubation readiness using spontaneous breathing trials in extremely preterm neonates. JAMA Pediatr 2020;174(2):178–185. DOI: 10.1001/jamapediatrics.2019.4868.
  109. Tomaszewska M, Stork E, Minich NM, et al. Pulmonary hemorrhage: Clinical course and outcomes among very low-birth-weight infants. Arch Pediatr Adolesc Med 1999;153(7):715–721. DOI: 10.1001/archpedi.153.7.715.
  110. Ren XL, Fu W, Liu J, et al. Lung ultrasonography to diagnose pulmonary hemorrhage of the newborn. J Matern Fetal Neonatal Med 2017;30(21):2601–2606. DOI: 10.1080/14767058.2016.1256997.
  111. Soldati G, Smargiassi A, Demi L, et al. Artifactual lung ultrasonography: It is a matter of traps, order, and disorder. Appl Sci 2020;10(5):1570. DOI: 10.3390/app10051570.
  112. Shee B, Anjum F, Rockoff BI. Pulmonary Hemorrhage. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:
  113. Miller DL, Dou C, Raghavendran K, et al. Variation of diagnostic ultrasound-induced pulmonary capillary hemorrhage with fraction of inspired oxygen. Ultrasound Med Biol 2020;46(8):1978–1985. DOI: 10.1016/j.ultrasmedbio.2020.04.005.
  114. Bhalla D, Naranje P, Jana M, et al. Pediatric lung ultrasonography: Current perspectives. Pediatr Radiol 2022;52(10):2038–2050. DOI: 10.1007/s00247-022-05412-9.
  115. Berlet T, Fehr T, Merz TM. Current practice of lung ultrasonography (LUS) in the diagnosis of pneumothorax: A survey of physician sonographers in Germany. Crit Ultrasound J 2014;6(1):16. DOI: 10.1186/s13089-014-0016-y.
  116. VanBerlo B, Wu D, Li B, et al. Accurate assessment of the lung sliding artefact on lung ultrasonography using a deep learning approach. Comput Biol Med 2022;148:105953. DOI: 10.1016/j.compbiomed.2022.105953.
  117. Lichtenstein D, Meziere G, Biderman P, et al. The comet-tail artifact: An ultrasound sign ruling out pneumothorax. Intensive Care Med 1999;25(4):383–388. DOI: 10.1007/s001340050862.
  118. Gargani L, Volpicelli G. How I do it: lung ultrasound. Cardiovasc Ultrasound 2014;12:25. DOI: 10.1186/1476-7120-12-25.
  119. Skopljanac I, Ivelja MP, Barcot O, et al. Role of lung ultrasound in predicting clinical severity and fatality in COVID-19 pneumonia. J Pers Med 2021;11(8). DOI: 10.3390/jpm11080757.
  120. Capasso L, Pacella D, Migliaro F, et al. Can lung ultrasound score accurately predict the need for surfactant replacement in preterm neonates? A systematic review and meta-analysis protocol. PLoS One 2021;16(7):e0255332. DOI: 10.1371/journal.pone.0255332.
  121. Alonso-Ojembarrena A, Lubian-Lopez SP. Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants. Pediatr Pulmonol 2019;54(9):1404–1409. DOI: 10.1002/ppul.24410.
  122. Sun YH, Du Y, Shen JR, et al. A modified lung ultrasound score to evaluate short-term clinical outcomes of bronchopulmonary dysplasia. BMC Pulm Med 2022;22(1):95. DOI: 10.1186/s12890-022-01885-4.
  123. Oulego-Erroz I, Alonso-Quintela P, Terroba-Seara S, et al. Early assessment of lung aeration using an ultrasound score as a biomarker of developing bronchopulmonary dysplasia: A prospective observational study. J Perinatol 2021;41(1):62–68. DOI: 10.1038/s41372-020-0724-z.
  124. Loi B, Vigo G, Baraldi E, et al. Lung ultrasound to monitor extremely preterm infants and predict bronchopulmonary dysplasia. A multicenter longitudinal cohort study. Am J Respir Crit Care Med 2021;203(11):1398–1409. DOI: 10.1164/rccm.202008-3131OC.
  125. Hoshino Y, Arai J, Miura R, et al. Lung ultrasound for predicting the respiratory outcome in patients with bronchopulmonary dysplasia. Am J Perinatol 2022;39(11):1229–1235. DOI: 10.1055/s-0040-1721848.
  126. Raimondi F, Migliaro F, Corsini I, et al. Lung ultrasound score progress in neonatal respiratory distress syndrome. Pediatrics 2021;147(4):e2020030528. DOI: 10.1542/peds.2020-030528.
  127. Avni EF, Cassart M, de Maertelaer V, et al. Sonographic prediction of chronic lung disease in the premature undergoing mechanical ventilation. Pediatr Radiol 1996;26(7):463–469. DOI: 10.1007/BF01377203.
  128. Pieper CH, Smith J, Brand EJ. The value of ultrasound examination of the lungs in predicting bronchopulmonary dysplasia. Pediatr Radiol 2004;34(3):227–231. DOI: 10.1007/s00247-003-1102-7.
  129. Gupta S, Prasanth K, Chen CM, et al. Postnatal corticosteroids for prevention and treatment of chronic lung disease in the preterm newborn. Int J Pediatr 2012;2012:315642. DOI: 10.1155/2012/315642.
  130. Abdelmawla M, Louis D, Narvey M, et al. A lung ultrasound severity score predicts chronic lung disease in preterm infants. Am J Perinatol 2019;36(13):1357–1361. DOI: 10.1055/s-038-1676975.
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