Background: B-lines in lung ultrasound can be used to estimate lung liquid. B-lines are ring-down artifacts that arise from alterations to subpleural lung parenchyma. Lung ultrasound has been used to differentiate between diseases causing respiratory symptoms in neonates. B-lines are also seen in healthy infants during postnatal adaptation. Static lung compliance is a measure of the elasticity of the lungs. Objectives: Our aim was to document lung ultrasound findings, static lung compliance and their relationship during postnatal adaptation in healthy term infants. Methods: Lung ultrasound and measurement of static lung compliance were performed in 34 infants at ages of 0-4 and 24 h. B-lines in lung ultrasound were scored using a 5-step scale. Separate ultrasound scores for the upper and lower fields were also calculated. Results: A significant decrease in the abundance of B-lines and a concomitant significant improvement in static lung compliance was observed from <4 to 24 h of age. At <4 h the B-lines were significantly more abundant in the lower fields. No significant correlation existed between lung ultrasound and static lung compliance. Conclusion: The concomitant decrease in the B-lines in ultrasound and the increase in lung compliance during the first 24 h are likely to reflect clearance of lung liquid.

Agricola E, Bove T, Oppizzi M, Marino G, Zangrillo A, Margonato A, Picano E: ‘Ultrasound comet-tail images': a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water. Chest 2005;127:1690-1695.
Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, Picano E: Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 2004;93:1265-1270.
Soldati G, Copetti R, Sher S: Sonographic interstitial syndrome: the sound of lung water. J Ultrasound Med 2009;28:163-174.
Martelius L, Janér C, Süvari L, Helve O, Lauerma K, Pitkänen O, Andersson S: Delayed lung liquid absorption after cesarean section at term. Neonatology 2013;104:133-136.
Raimondi F, Migliaro F, Sodano A, Umbaldo A, Romano A, Vallone G, Capasso L: Can neonatal lung ultrasound monitor fluid clearance and predict the need of respiratory support? Crit Care 2012;16:R220.
Raimondi F, Migliaro F, Sodano A, Ferrara T, Lama S, Vallone G, Capasso L: Use of neonatal chest ultrasound to predict noninvasive ventilation failure. Pediatrics 2014;134:e1089-e1094.
Vergine M, Copetti R, Brusa G, Cattarossi L: Lung ultrasound accuracy in respiratory distress syndrome and transient tachypnea of the newborn. Neonatology 2014;106:87-93.
Copetti R, Cattarossi L, Macagno F, Violino M, Furlan R: Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis. Neonatology 2008;94:52-59.
Piastra M, Yousef N, Brat R, Manzoni P, Mokhtari M, De Luca D: Lung ultrasound findings in meconium aspiration syndrome. Early Hum Dev 2014;90(suppl 2):S41- S43.
Copetti R, Cattarossi L: The ‘double lung point': an ultrasound sign diagnostic of transient tachypnea of the newborn. Neonatology 2007;91:203-209.
Nusmeier A, Vrancken S, de Boode WP, van der Hoeven JG, Lemson J: Validation of extravascular lung water measurement by transpulmonary thermodilution in a pediatric animal model. Pediatr Crit Care Med 2014;15:e226-e233.
Gappa M, Colin AA, Goetz I, Stocks J; ERS/ATS Task Force on Standards for Infant Respiratory Function Testing; European Respiratory Society/American Thoracic Society: Passive respiratory mechanics: the occlusion techniques. Eur Respir J 2001;17:141-148.
Helve O, Andersson S, Kirjavainen T, Pitkänen OM: Improvement of lung compliance during postnatal adaptation correlates with airway sodium transport. Am J Respir Crit Care Med 2006;173:448-452.
Oshima K, Kunimoto F, Hinohara H, Hayashi Y, Kanemaru Y, Takeyoshi I, Kuwano H: Evaluation of respiratory status in patients after thoracic esophagectomy using PiCCO system. Ann Thorac Cardiovasc Surg 2008;14:283-288.
Bataille B, Rao G, Cocquet P, Mora M, Masson B, Ginot J, Silva S, Moussot PE: Accuracy of ultrasound B-lines score and E/Ea ratio to estimate extravascular lung water and its variations in patients with acute respiratory distress syndrome. J Clin Monit Comput 2015;29:169-176.
Hooper SB, Kitchen MJ, Wallace MJ, Yagi N, Uesugi K, Morgan MJ, Hall C, Siu KK, Williams IM, Siew M, Irvine SC, Pavlov K, Lewis RA: Imaging lung aeration and lung liquid clearance at birth. FASEB J 2007;21:3329-3337.
van Vonderen JJ, Roest AA, Siew ML, Walther FJ, Hooper SB, te Pas AB: Measuring physiological changes during the transition to life after birth. Neonatology 2014;105:230-242.
O'Brodovich HM: Immature epithelial Na+ channel expression is one of the pathogenetic mechanisms leading to human neonatal respiratory distress syndrome. Proc Assoc Am Physicians 1996;108:345-355.
Siew ML, Wallace MJ, Allison BJ, Kitchen MJ, te Pas AB, Islam MS, Lewis RA, Fouras A, Yagi N, Uesugi K, Hooper SB: The role of lung inflation and sodium transport in airway liquid clearance during lung aeration in newborn rabbits. Pediatr Res 2013;73:443-449.
Bland RD, McMillan DD, Bressack MA, Dong L: Clearance of liquid from lungs of newborn rabbits. J Appl Physiol 1980;49:171-177.
Kitchen MJ, Siew ML, Wallace MJ, Fouras A, Lewis RA, Yagi N, Uesugi K, Te Pas AB, Hooper SB: Changes in positive end-expiratory pressure alter the distribution of ventilation within the lung immediately after birth in newborn rabbits. PLoS One 2014;9:e93391.
Helve O, Pitkänen O, Kirjavainen T, Andersson S: Sodium transport in airway epithelium correlates with lung compliance in healthy newborn infants. J Pediatr 2005;146:273-276.
Gargani L, Lionetti V, Di Cristofano C, Bevilacqua G, Recchia FA, Picano E: Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets. Crit Care Med 2007;35:2769-2774.
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