This work on neonatal chest ultrasound has shown that the persistence of a hyperechogenic, "white lung" image correlates with severe distress in 28 infants. We investigate the persistent “white lung” ultrasound image in predicting the success or failure of noninvasive ventilation.

28 infants with mild to moderate respiratory distress (Silverman-Anderson score) were enrolled. After 2 hours, chest ultrasound and RX were performed. The Lung ultrasound was classified as Type 1: the persistence of a hyperechogenic, "white lung" image correlates with severe distress in the preterm infant; Type 2: presence of multiple B lines; Type 3: Normal, with A lines and not B lines. Chest radiograph also was examined and graded by an experienced radiologist blind to the infants clinical condition.

We enrolled 28 patients: 15 were classified as type1, 13 as type 2-3. There were no significant differences in comparing the diagnostic accuracybetween chest US and chest X-Ray.

Chest ultrasound is a fast and safe method for the diagnosis and follow-up of respiratory distress. Future studies should address whether including ultrasonography in the management of neonatal moderate RD confers clinical advantages.

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