Background: Neonatal respiratory distress syndrome (NRDS) is a leading contributor to neonatal morbidity and mortality, particularly in neonatal intensive care units (NICUs). Historically, diagnosis relied on clinical assessment, arterial blood gas parameters, and chest X-ray (CXR). However, repeated CXR exposure introduces neonates—especially preterm infants—to ionizing radiation, linked to long-term outcomes, including elevated cancer risk. In this context, lung ultrasound (LUS) has emerged as a compelling alternative, offering several advantages: it is free of radiation hazards, enables bedside application, is repeatable, and user-friendly.
Objective: This review critically examines the comparative utility of lung ultrasound versus chest X-ray in evaluating pulmonary pathologies among neonates, with emphasis on determining the superior modality in clinical practice.
Conclusions: Lung ultrasound warrants integration as an adjunctive technique alongside chest X-ray within diagnostic protocols for neonatal respiratory distress syndrome. Its introduction into routine practice offers a non-ionizing imaging approach that may reduce the frequency of radiographic studies, thereby mitigating radiation exposure in this vulnerable population. Furthermore, from an economic standpoint, LUS is a cost-efficient alternative, as it avoids the need for expensive radiographic infrastructure and consumables. The average expenditure per ultrasound is lower than the cumulative costs associated with serial chest X-rays, underscoring its value in NICU settings with high imaging demands. Ultrasound’s diagnostic precision, ease of access, and absence of contraindications render it invaluable, especially given the emphasis on minimizing radiation risks in neonatology.
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