Intensive Care Medicine

, Volume 45, Issue 4, pp 508–511 | Cite as

What’s new in lung ultrasound in the critically ill or injured child

  • Philippe DurandEmail author
  • Daniele De Luca
  • Pierre Tissieres
What's New in Intensive Care

Lung ultrasonography (LUS) is a well-established technique in adult critical care, but remains insufficiently recognized in children and infants. The purpose of this short review is to describe the rapidly growing field of point-of-care LUS in critically ill and injured children.

LUS interpretation is based on the analysis of dynamic artifacts, mostly related to the air–fluid ratio and lung density. All LUS patterns originate from the pleural line because LUS, as a surface technique, is not able to detect consolidation in the deep lung far from the surface. Although not scientifically demonstrated, because of their small lung volume, children—and specifically infants—may be more suitable for in-depth analysis of the lung parenchyma and identification of deep alveolar consolidations, atelectasis and interstitial infiltrates. Similarly, the use of linear probes in infants and curvilinear probes in older children is preferred. LUS semiology is well characterized and identifies normal lung...


  1. 1.
    Ord HL, Griksaitis MJ (2018) 15-minute consultation: using point of care ultrasound to assess children with respiratory failure. Arch Dis Child Educ Pract Ed. (Epub ahead of print) Google Scholar
  2. 2.
    Ambroggio L, Sucharew H, Rattan MS, O’Hara SM, Babcock DS, Clohessy C et al (2016) Lung ultrasonography: a viable alternative to chest radiography in children with suspected pneumonia? J Pediatr 176(93–98):e7. Google Scholar
  3. 3.
    Escourrou G, De Luca D (2016) Lung ultrasound decreased radiation exposure in preterm infants in a neonatal intensive care unit. Acta Paediatr 105(5):e237–e239. CrossRefGoogle Scholar
  4. 4.
    Jones BP, Tay ET, Elikashvili I (2016) Feasibility and safety of substituting lung ultrasonography for chest radiography when diagnosing pneumonia in children a randomized controlled trial. Chest 150(1):131–138. CrossRefGoogle Scholar
  5. 5.
    International Liaison Committee on Lung Ultrasound (ILC-LUS) for the International Consensus Conference on Lung Ultrasound (ICC-LUS), Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G et al (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38(4):577–591. CrossRefGoogle Scholar
  6. 6.
    Pereda MA, Chavez MA, Hooper-Miele CC, Gilman RH, Steinhoff MC, Ellington LE et al (2015) Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics 135(4):714–722. CrossRefGoogle Scholar
  7. 7.
    Caiulo VA, Gargani L, Caiulo S, Fisicaro A, Moramarco F, Latini G et al (2011) Lung ultrasound in bronchiolitis: comparison with chest X-ray. Eur J Pediatr 170(11):1427–1433. CrossRefGoogle Scholar
  8. 8.
    Basile V, Di Mauro A, Scalini E, Comes P, Lof I, Mostert M et al (2015) Lung ultrasound: a useful tool in diagnosis and management of bronchiolitis. BMC Pediatr. Google Scholar
  9. 9.
    Taveira M, Yousef N, Miatello J, Roy C, Claude C, Boutillier B et al (2018) Can a simple lung ultrasound score predict length of ventilation for infants with severe acute viral bronchiolitis? Arch Fr Pediatr 25(2):112–117. CrossRefGoogle Scholar
  10. 10.
    Acosta CM, Maidana GA, Jacovitti D, Belaunzarán A, Cereceda S, Rae E et al (2014) Accuracy of transthoracic lung ultrasound for diagnosing anesthesia-induced atelectasis in children. Anesthesiology 120(6):1370–1379. CrossRefGoogle Scholar
  11. 11.
    Corradi F, Brusasco C, Pelosi P (2014) Chest ultrasound in acute respiratory distress syndrome. Curr Opin Crit Care 20(1):98–103. CrossRefGoogle Scholar
  12. 12.
    Riviello ED, Kiviri W, Twagirumugabe T et al (2016) Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali Modification of the Berlin Definition. Am J Respir Crit Care Med 193:52–59. CrossRefGoogle Scholar
  13. 13.
    Haddam M, Zieleskiewicz L, Perbet S, Baldovini A, Guervilly C, Arbelot C et al (2016) Lung ultrasonography for assessment of oxygenation response to prone position ventilation in ARDS. Intensive Care Med 42(10):1546–1556. CrossRefGoogle Scholar
  14. 14.
    Bouhemad B, Brisson H, Le-Guen M, Arbelot C, Lu Q, Rouby J-J (2011) Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med 183(3):341–347. CrossRefGoogle Scholar
  15. 15.
    De Martino L, Yousef N, Ben-Ammar R, Raimondi F, Shankar-Aguilera S, De Luca D (2018) Lung ultrasound score predicts surfactant need in extremely preterm neonates. Pediatrics 142(2):e20180463. CrossRefGoogle Scholar
  16. 16.
    Raimondi F, Rodriguez Fanjul J, Aversa S, Chirico G, Yousef N, De Luca D et al (2016) Lung ultrasound for diagnosing pneumothorax in the critically ill neonate. J Pediatr 175:74–78. CrossRefGoogle Scholar
  17. 17.
    Alrajab S, Youssef AM, Akkus NI et al (2013) Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax: review of the literature and meta-analysis. Crit Care 17:R208. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  1. 1.Division of Pediatric Intensive Care and Neonatal MedicineParis South University HospitalsLe Kremlin-BicêtreFrance
  2. 2.Division of Pediatrics and Neonatal Intensive CareParis South University Hospital and INSERM-U999 LabEx - LERMITClamartFrance
  3. 3.Institute of Integrative Biology of the Cell, CNRS, CEA, Univ. Paris Sud, Paris Saclay UniversityGif sur YvetteFrance

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