Applications of lung ultrasound in preterm infants: implications for respiratory distress syndrome and bronchopulmonary dysplasia.

Lung ultrasound (LUS) has emerged as a promising bedside imaging modality in neonatal intensive care units, offering real-time assessment of lung aeration without exposure to ionizing radiation. These advantages are particularly relevant for preterm infants, who are vulnerable to cumulative radiation exposure and evolving pulmonary disease. In this narrative review, we synthesize current evidence on the functional clinical applications of lung ultrasound in preterm infants. We focus on how LUS has been studied to guide early respiratory management, predict the need for surfactant and escalation of respiratory support, assess extubation readiness, identify infants at increased risk for bronchopulmonary dysplasia, and monitor disease trajectory and response to therapy throughout the NICU course, including emerging data on longer-term respiratory outcomes. While available studies demonstrate promising diagnostic and prognostic value, interpretation is limited by heterogeneity in acquisition protocols, scoring systems, timing of assessment, and operator dependence. Further multicenter studies with standardized protocols are needed to define the role of LUS in routine neonatal respiratory care.