Background: Delayed postnatal removal of lung liquid may result in respiratory distress, which is more common in infants born by cesarean section. Vertical artefacts (B-lines) arising from the lung surface in lung ultrasound have been shown to correlate with the liquid content of the lungs. Objectives: We studied whether lung ultrasound could be used for the assessment of postnatal lung liquid in healthy term infants born vaginally and by cesarean section. Methods: Lung ultrasound was performed 1, 3 and 24 h after birth to 22 vaginally born infants and 20 infants born by elective cesarean section. The abundance of B-lines was scored for each infant and time point by two independent observers blinded to the mode of delivery and time point on the examination on a five-step scale. Results: In both groups, a significant decrease in abundance of B-lines, indicative of lung liquid absorption, was observed during the first 24 h. 3 h after birth cesarean section was associated with significantly higher lung liquid content than vaginal delivery. Conclusion: The noninvasive bedside ultrasound method for estimation of lung liquid is a promising tool for the early identification of infants at risk for pulmonary maladaptation.

Our results show that lung ultrasound in assessment of postoperative EVLW predicted length of mechanical ventilation and stay in the PICU, and it had less interobserver variability than CXR. Accordingly, lung ultrasound may complement CXR in assessment of lung edema after surgery for congenital heart defect. Pediatr Pulmonol. 2017;52:345-352. © 2016 Wiley Periodicals, Inc.

The impaired airway epithelial amiloride-sensitive Na transport activity in profoundly hypoxemic children with cyanotic congenital heart defect may hinder defense against lung edema after cardiac surgery.

Background: B-lines in lung ultrasound can be used to estimate lung liquid. B-lines are ring-down artifacts that arise from alterations to subpleural lung parenchyma. Lung ultrasound has been used to differentiate between diseases causing respiratory symptoms in neonates. B-lines are also seen in healthy infants during postnatal adaptation. Static lung compliance is a measure of the elasticity of the lungs. Objectives: Our aim was to document lung ultrasound findings, static lung compliance and their relationship during postnatal adaptation in healthy term infants. Methods: Lung ultrasound and measurement of static lung compliance were performed in 34 infants at ages of 0-4 and 24 h. B-lines in lung ultrasound were scored using a 5-step scale. Separate ultrasound scores for the upper and lower fields were also calculated. Results: A significant decrease in the abundance of B-lines and a concomitant significant improvement in static lung compliance was observed from <4 to 24 h of age. At <4 h the B-lines were significantly more abundant in the lower fields. No significant correlation existed between lung ultrasound and static lung compliance. Conclusion: The concomitant decrease in the B-lines in ultrasound and the increase in lung compliance during the first 24 h are likely to reflect clearance of lung liquid.