EFFICACY OF ULTRASOUND MONITORING OF RECRUITMENT MANEUVER IN NEWBORNS WITH PULMONARY ATELECTASIS: A CLINICAL CASE STUDY

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Real-time, routine bedside diagnosis of treatment effi cacy without radiation exposure is the greatest challenge facing intensive care medicine in respiratory disease, including neonates. Ultrasound for lung monitoring is a major step forward in the timely diagnosis of respiratory disease. The use of a recruitment maneuver has been shown to be eff ective in the treatment of atelectasis and safe while monitoring lung status. This article presents the experience of using an ultrasound- guided lung recruitment maneuver and a clinical case to demonstrate it.A child with respiratory distress syndrome was diagnosed with pulmonary atelectasis on day 3. A lung ultrasound- guided recruitment maneuver was performed using the method of controlled gradual increase of PEEP from 5 cm to 8 cm H2O for 2 minutes and then to 10-11 cm H2O for the next 2 minutes in PCV mode (pressure- controlled ventilation). PEEP was then titrated (decreased) to the minimum inspiratory pressure (5 cm H2O). SpO2 and capnography were closely monitored, and lung ultrasound was performed every 2 minutes during pressure increase to monitor status. Ultrasound imaging showed improvement of lung ventilation in the aff ected area during the recruitment maneuver (fi rst reduction of B-lines, then normal pattern with A-lines on the background of B-lines, normalization of respiratory movement of the pleura). Chest x-ray confi rmed resolution of atelectasis.The Bioethics Committee of ME «Regional Medical Center of Family Health» DRC» has approved the publication of materials.All anamnestic data, examination results and photographic materials were published with the written informed consent of the parents of the newborn.Conclusions. Ultrasound examination is a valid and appropriate diagnostic method that allows clinicians to obtain non-invasive, rapid, bedside information about the lung status of newborns with pulmonary atelectasis during the recruitment maneuver, avoiding the risks associated with radiography.