Lung ultrasound- can it be potentially painful for a newborn?

INTRODUCTION: We aimed to analyze changes in vital parameters and assess behavioral response to lung ultrasound (LUS) in preterm and term newborns hospitalized in the neonatal intensive care unit (NICU).
METHODS: Three groups of neonates (term, 370/7–416/7 weeks; moderate to late preterm, 320/7–366/7; and very preterm, <320/7) were included. Response to LUS was assessed using heart rate (HR), blood oxygen saturation (SpO2), and Neonatal Infant Pain Scale (NIPS). Reactions to LUS, blood sampling, and nappy change were compared.
RESULTS: Seventy-one infants were enrolled: 30 term, 21 moderate to late preterm, and 20 very preterm. An increase in mean HR and decrease in median SpO2 during LUS were observed (p < 0.001), in all analyzed groups, whereas the median NIPS score was 3. During LUS, 38% term infants experienced pain according to NIPS. The same was observed for 47% and 35% of infants in the moderate to late preterm and very preterm groups. The trend of NIPS increased along with the higher intensity of the stimulus. The highest NIPS values were related to blood sampling, moderate to LUS, and lowest to nappy change (p < 0.001).
DISCUSSION AND CONCLUSION: As LUS affects vital parameters and may be perceived as potentially painful in >1/3 newborns, indications for each examination and adequate pain management should be always considered.