Journal of perinatology : official journal of the California Perinatal Association · 2026
Feasibility of lung ultrasound-guided positive end-expiratory pressure adjustment in newborns.
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Møller Anna Holst, Heiring Christian, Feldskou Sebastian Pornpakdee, Klebermass-Schrehof Katrin, Lauridsen Mette Høj, Kyng Kasper Jacobsen
Аннотация
OBJECTIVE: To evaluate whether an ultrasound-guided lung recruitment manoeuvre (LRM) can identify a positive end-expiratory pressure (PEEP) associated with improved aeration compared with clinically set PEEP during non-invasive respiratory support.
STUDY DESIGN: Feasibility study of 11 spontaneously breathing infants on continuous positive airway pressure or non-invasive ventilation. PEEP was increased stepwise by 2 cmH2O from 4 to 10 cmH2O. The PEEP with the lowest lung ultrasound score was recorded along with vital parameters.
RESULTS: In 10 of 11 infants (91%; 95% confidence interval 62-99, p = 0.01), the LRM identified a PEEP with a lower lung ultrasound score than the clinically set level; five infants required a higher and five a lower PEEP. Clinical parameters were stable or improved.
CONCLUSION: In this pilot cohort, lung ultrasound-guided PEEP adjustment appeared feasible and was associated with favourable short-term changes in lung aeration. Larger studies are required to validate these preliminary findings and determine clinical utility.
STUDY DESIGN: Feasibility study of 11 spontaneously breathing infants on continuous positive airway pressure or non-invasive ventilation. PEEP was increased stepwise by 2 cmH2O from 4 to 10 cmH2O. The PEEP with the lowest lung ultrasound score was recorded along with vital parameters.
RESULTS: In 10 of 11 infants (91%; 95% confidence interval 62-99, p = 0.01), the LRM identified a PEEP with a lower lung ultrasound score than the clinically set level; five infants required a higher and five a lower PEEP. Clinical parameters were stable or improved.
CONCLUSION: In this pilot cohort, lung ultrasound-guided PEEP adjustment appeared feasible and was associated with favourable short-term changes in lung aeration. Larger studies are required to validate these preliminary findings and determine clinical utility.