International Perspectives: Point-of-Care Chest Ultrasound in the Neonatal Intensive Care Unit: An Italian Perspective

Abstract

Lung ultrasound outperforms conventional radiology in the emergency diagnosis of pneumothorax and pleural effusions. Neonatologists and pediatricians are now adapting lung ultrasound to their specific clinical issues. The normal image is relatively unchanged throughout the age span, whereas progressively fading B-lines (comet-tail artifacts) describe the fluid-to-air transition of the neonatal lung. Also, an homogeneous white (hyperechogenic) lung with pleural image abnormalities and absence of spared areas is accurate in diagnosing respiratory distress syndrome. The evidence of bilateral confluent B-lines in the dependent areas of the lung (‘‘white lung’’) and normal or near-normal appearance of the lung in the superior fields is highly sensitive and specific for transient tachypnea of the newborn. Infantile pneumonia has recently been proved to be accurately diagnosed by ultrasound after a short training period. In summary, chest ultrasonography is not yet ready to replace conventional chest radiology. However, when appropriately applied, a lung ultrasound scan can save time and radiation exposure to achieve a critical diagnosis.