{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T06:34:26Z","timestamp":1779258866086,"version":"3.51.4"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The use of recruitment maneuvers (RMs) is suggested to improve severe oxygenation failure in patients with acute respiratory distress syndrome (ARDS). Lung ultrasound (LUS) is a non-invasive, safe, and easily repeatable tool. It could be used to monitor the lung recruitment process in real-time. This paper aims to evaluate bedside LUS for assessing PEEP-induced pulmonary reaeration during RMs in pediatric patients. A case of a child with severe ARDS due to Haemophilus influenzae infection is presented. Due to his poor clinical, laboratory, and radiological evolution, he was placed on venovenous extracorporeal membrane oxygenation (ECMO). Despite all measures, severe pulmonary collapse prevented proper improvement. Thus, RMs were indicated, and bedside LUS was successfully used for monitoring and assessing lung recruitment. The initial lung evaluation before the maneuver showed a tissue pattern characterized by a severe loss of lung aeration with dynamic air bronchograms and multiple coalescent B-lines. While raising a PEEP of 30 mmH2O, LUS showed the presence of A-lines, which was considered a predictor of reaeration in response to the recruitment maneuver. The LUS pattern could be used to assess modifications in the lung aeration, evaluate the effectiveness of RMs, and prevent lung overdistension.<\/jats:p>","DOI":"10.3390\/children9060789","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T07:05:07Z","timestamp":1653635107000},"page":"789","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Lung Recruitment Maneuvers Assessment by Bedside Lung Ultrasound in Pediatric Acute Respiratory Distress Syndrome"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-5938","authenticated-orcid":false,"given":"Mireia","family":"Mor Conejo","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9127-5939","authenticated-orcid":false,"given":"Carmina","family":"Guitart Pardellans","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"},{"name":"Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Fres\u00e1n Ruiz","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"},{"name":"Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5289-6609","authenticated-orcid":false,"given":"Daniel","family":"Penela S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Jos\u00e9","family":"Cambra Lasaosa","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"},{"name":"Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2041-4425","authenticated-orcid":false,"given":"Iolanda","family":"Jordan Garcia","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"},{"name":"Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Barcelona, Spain"},{"name":"Pediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de D\u00e9u, CIBERESP, Esplugues de Llobregat, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2686-116X","authenticated-orcid":false,"given":"M\u00f2nica","family":"Balaguer Gargallo","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"},{"name":"Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1181-3547","authenticated-orcid":false,"given":"Mart\u00ed","family":"Pons-\u00d2dena","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Service, Hospital Sant Joan de D\u00e9u, University of Barcelona, 08950 Barcelona, Spain"},{"name":"Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de D\u00e9u, Esplugues de Llobregat, 08950 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S0140-6736(21)00439-6","article-title":"Acute Respiratory Distress Syndrome","volume":"398","author":"Meyer","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1056\/NEJM200005043421806","article-title":"The Acute Respiratory Distress Syndrome","volume":"342","author":"Ware","year":"2000","journal-title":"N. 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