Ultrasound in neonatal lung disease

Lung disease is the most common cause of neonatal respiratory distress, which can result in respiratory failure and death in severe cases. In the United States, the mortality of neonatal respiratory failure is approximately 11%, and the rate can go up to 32% in China (1,2). Thus, identification of the etiology of lung disease is important for neonatologists. Traditionally, chest X-ray has been considered as the most valuable imaging modality for the diagnosis of lung diseases, but it unavoidably causes radiation damage to the patient. Neonates are susceptible to radiation because they have rapidly dividing cells that cannot repair mutated DNA. According to one study, the risk of cancer induction in infants receiving a single small dose of radiation is 2–3 times higher than the average population and 6–9 times higher than the risk from an exposure of a 60-year-old patient (3). In recent years, a new imaging application has been introduced in clinical practice—lung ultrasound. Several studies have demonstrated that lung ultrasound is an accurate and reliable technique for the diagnosis of neonatal lung diseases (4,5). Other advantages of lung ultrasound include that it is non-ionizing, easy to operate, and the imaging is performed in real-time, thus making it as a potential tool to be used in neonatal intensive care units (NICUs). In this paper, we will introduce the current state of knowledge about neonatal lung ultrasound, show the imaging of typical cases and provide a very good starting point for residents or novices to get a better understanding of lung ultrasound