Abstract
The rapid identification and management of air leak syndrome in the neonatal intensive
care unit is critical to prevent and/or minimize short- and long-term complications.
Traditionally, chest X-ray is used to diagnose pneumothorax or pneumomediastinum.
However, point-of-care ultrasound is increasingly being used for procedural and diagnostic
purposes. Current ultrasound guidelines recommend specific criteria to diagnose pneumothorax
in newborns including sharp A-lines, absence of B-lines, lack of shimmering of the
pleural line, and the presence of a lung point. Pneumomediastinum may have similar
ultrasound characteristics. In this case report, we present two cases of pneumomediastinum
in newborns, describe the associated ultrasound findings, and review some of the criteria
to differentiate from pneumothorax, including the presence of a still lung point.
A high index of suspicion for pneumomediastinum should be maintained when using ultrasound
to diagnose air leak given the overlapping sonographic features with pneumothorax.
This distinction is of particular importance if evacuation of air by needle thoracentesis
or the placement of a chest tube is under consideration.
Keywords
POCUS - pneumothorax - pneumomediastinum - lung sliding - ultrasound - air leak syndrome
- newborn - lung point
