Lung Ultrasound Assessment of Regional Distribution of Pulmonary Edema and Atelectasis in Infants with Evolving Bronchopulmonary Dysplasia.

Preterm infants are at risk for bronchopulmonary dysplasia (BPD) due to prolonged respiratory support. Studies have described differences in the regional distribution of lung ventilation (non-dependent (NDL) vs. dependent (DL)). The aim of this study was to use LUS to compare regional distribution of pulmonary edema and atelectasis in infants with evolving BPD. We prospectively performed LUS in premature infants with evolving BPD. On each side, three lung areas (NDL/anterior, lateral, and DL/posterior) were examined for the presence of pulmonary edema and atelectasis. Pulmonary edema scores were assigned based on the number of B-lines, and atelectasis scores were assigned based on the presence/absence of atelectasis. 38 premature infants were enrolled. The NDL showed more pulmonary edema and atelectasis compared to the DL ( = 0.003, = 0.049, respectively) and compared to the lateral lung ( =< 0.001, = 0.004, respectively). There was no difference between the lateral and DL ( = 0.188, = 0.156, respectively). There was no difference between the right and the left lung ( = 0.223, = 0.656, respectively). In this cohort of preterm infants with evolving BPD, lung disease was unevenly distributed, with more pulmonary edema and atelectasis in the NDL regions compared to the DL or lateral regions.