Lung Ultrasound in Pediatrics and Neonatology: An Update

Abstract

The potential role of ultrasound for the diagnosis of pulmonary diseases is a recent field of research, because, traditionally, lungs have been considered unsuitable for ultrasonography for the high presence of air and thoracic cage that prevent a clear evaluation of the organ. The peculiar anatomy of the pediatric chest favors the use of lung ultrasound (LUS) for the diagnosis of respiratory conditions through the interpretation of artefacts generated at the pleural surface, correlating them to disease-specific patterns. Recent studies demonstrate that LUS can be a valid alternative to chest X-rays for the diagnosis of pulmonary diseases, especially in children to avoid excessive exposure to ionizing radiations. This review focuses on the description of normal and abnormal findings during LUS of the most common pediatric pathologies. Current literature demonstrates usefulness of LUS that may become a fundamental tool for the whole spectrum of lung pathologies to guide both diagnostic and therapeutic decisions.

Lung Ultrasound in the Neonatal Intensive Care Unit: Does It Impact Clinical Care?

“…Atelectasis is demonstrated as a consolidation with the anechoic border and a disruption of A-lines [ 8 , 31 ]. Complete atelectasis can cause an absence of lung sliding and hepatization of the lung on ultrasound [ 1 , 31 ]. Lung pulse can also be observed in severe atelectasis, where the atelectatic lung appears to be pulsating with the beats of the heart [ 31 ].…”

“…Neonatal point-of-care ultrasound (POCUS) was first described in the 1960s, with increasing applications being reported over the past decade [ 1 , 2 , 3 ]. Neonatal lung ultrasound (LUS) is used in emergent situations, differentiating neonatal respiratory pathologies, and predicting neonatal morbidity [ 2 ].…”

“…Neonatal lung ultrasound (LUS) is used in emergent situations, differentiating neonatal respiratory pathologies, and predicting neonatal morbidity [ 2 ]. LUS can be brought to the bedside of the fragile neonate, used serially, and does not expose the neonate to ionizing radiation [ 1 , 4 ]. Functional and descriptive applications make it a high-fidelity tool to aid in distinguishing the various causes of neonatal respiratory failure and to guide in management [ 2 , 5 ].…”

“…LUS is especially useful in neonatology due to the neonatal chest anatomy, unique ossification of the thorax, and respiratory pathologies [ 1 , 8 ]. A linear high frequency probe, typically >10 MHz, is commonly used in neonatal LUS [ 1 , 9 ]. The high frequency probe is utilized due to its high resolution with a superficial depth of penetration.…”

“…B-lines or comet tail artifacts represent reverberation artifacts from interstitial edema or scarring of the interlobar septae in the lung parenchyma [ 1 , 8 ]. B-lines are represented as vertical lines extending from the pleural line to the edge of the screen and can be seen moving with lung sliding ( Figure 2 , Supplementary Materials Video 1A ).…”