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Ultrasound-Guided Lung Recruitment in a 3-Month-Old Infant With Acute Respiratory Distress Syndrome

Sameshima, Yoshino Tamaki MD*; de Almeida, João Fernando Lourenço MD; Silva, Murilo Marques Almeida MD; Remondini, Renata RT; Haddad, Luciana Branco RT; Neto, Miguel José Francisco MD; Funari, Marcelo Buarque de Gusmão MD

doi: 10.1097/RUQ.0000000000000072
Case Reports

Abstract: The reversal of lung collapse is one of the challenges of lung injury prevention in pediatric acute respiratory distress syndrome. In this case, lung recruitment maneuver (RM) with positive end-expiratory pressure under computed tomography guidance is the procedure of choice, but cumulative ionizing radiation exposure is a major radiologic concern, especially in infants. Real-time guidance of lung recruitment under bedside lung ultrasound (US) assessment in adults has shown to be an effective procedure for performing RM that avoids ionizing radiation overexposure. We report a case of US-guided lung recruitment procedure applied in an infant with severe acute respiratory distress syndrome and advocate that the lung US-guided RM in infants is a feasible and safe procedure.

*Pediatric Radiology, †Pediatric Intensive Care Unit, and ‡Diagnostic Imaging Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.

Received for publication October 9, 2013; accepted February 6, 2014.

The authors declare no conflict of interest.

Reprints: Yoshino Tamaki Sameshima, MD, Diagnostic Imaging Department, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701, São Paulo, SP, Brazil (e-mail:

All authors participated in writing the case report.

© 2014 by Lippincott Williams & Wilkins