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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

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