Open AccessReview Lung Ultrasound-Guided Surfactant Therapy in Neonatal Pneumothorax and Pulmonary Hemorrhage: Pathophysiology, Diagnostic Ultrasonography, and Emerging Clinical Approaches 1 Doctoral School, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade”, 540142 Targu Mures, Romania 2 Clinical Department of Neonatology, Sf. Ioan cel Nou Emergency Hospital, 720224 Suceava, Romania 3 Department of Pediatric Surgery, Sf. Ioan cel Nou Emergency Hospital, 720224 Suceava, Romania 4 Faculty of Medicine and Biological Sciences, Ștefan cel Mare University of Suceava, 720229 Suceava, Romania 5 Clinical Department of Pediatrics, Sf. Ioan cel Nou Emergency Hospital, 720224 Suceava, Romania 6 Department of Neonatology, Filantropia Clinical Hospital, 011132 Bucharest, Romania 7 Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania 8 Department of Puericulture and Neonatology, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, Romania 9 Department of Neonatology, Clinical County Emergency Hospital No. 1 Timisoara, 300098 Timisoara, Romania 10 Department of Obstetrics and Gynecology, Sf. Ioan cel Nou Emergency Hospital, 720224 Suceava, Romania add Show full affiliation list remove Hide full affiliation list * Authors to whom correspondence should be addressed. Children 2026, 13(6), 784; https://doi.org/10.3390/children13060784 (registering DOI) Submission received: 5 May 2026 / Revised: 27 May 2026 / Accepted: 1 June 2026 / Published: 4 June 2026 Abstract Background and Objectives: Lung ultrasound (LUS) has fundamentally transformed neonatal respiratory diagnostics, offering a radiation-free, bedside-applicable modality capable of guiding surfactant therapy, characterizing pulmonary pathology, and monitoring treatment response in real time. While surfactant replacement therapy is firmly established for neonatal respiratory distress syndrome (RDS), its role in acute complications—specifically pulmonary hemorrhage (PH) and pneumothorax (PTX)—remains uncertain and heterogeneous in clinical practice. This review examines how LUS-based phenotyping can improve the diagnostic precision and therapeutic sequencing of surfactant administration in these high-risk scenarios, and how comorbidities such as hemodynamically significant patent ductus arteriosus, persistent pulmonary hypertension, sepsis, and coagulopathy modulate clinical outcomes. Materials and Methods: We conducted a structured narrative review of studies published from 2020 onward, sourced from PubMed, Web of Science, Semantic Scholar, and Mendeley, using PRISMA-inspired selection principles. The search combined terms including “lung ultrasound,” “neonatal POCUS,” “surfactant therapy,” “pulmonary hemorrhage,” “neonatal pneumothorax,” and “LUS score.” Studies focusing on neonatal populations, clinical LUS applications, and surfactant use in PH and PTX were prioritized. Results: Quantitative LUS scoring systems (range 0–18) predict surfactant need and re-dosing with AUC values of 0.85–0.87, outperforming clinical estimates alone. In PH, LUS reveals dense consolidation with alveolar flooding patterns, guiding the timing of rescue surfactant after hemodynamic stabilization; response monitoring via serial LUS is feasible and informative. In PTX, hallmark signs—absent lung sliding, loss of B-lines, and the pathognomonic lung point—allow diagnosis within seconds, guiding immediate thoracentesis and subsequent surfactant administration if underlying RDS is confirmed. Nationally implemented LUS protocols in neonatal intensive care units have demonstrated significant reductions in radiation exposure without compromising diagnostic accuracy. Conclusions: LUS-guided decision algorithms—integrating ultrasonographic phenotyping, quantitative scoring, and hemodynamic assessment—represent the current best framework for individualizing surfactant therapy in neonatal PH and PTX. Standardization of POCUS training and protocol implementation in neonatal units is essential. Prospective multicenter trials are urgently needed to define optimal indications, timing, and dosing in these vulnerable populations. 1. Introduction Beyond RDS, a subset of critically ill neonates develops acute complications—most notably pulmonary hemorrhage (PH) and pneumothorax (PTX)—that challenge even experienced neonatal teams. These conditions share a common need for rapid, accurate diagnosis and individualized therapeutic response, yet neither has been the subject of large, definitive randomized trials regarding surfactant use. Clinical decision-making therefore depends heavily on pathophysiological reasoning, bedside assessment, and increasingly, real-time imaging [ 6, 7]. This review synthesizes current evidence on surfactant administration in neonatal PH and PTX through a deliberate ultrasonographic lens. We examine the pathophysiology of surfactant dysfunction in each condition, the diagnostic role of LUS as a primary imaging tool, validated scoring systems and their clinical cut-offs, the influence of hemodynamic comorbidities on therapeutic response, and the emerging evidence base for minimally invasive surfactant administration (LISA) in complex neonatal scenarios. Our objective is to offer a clinically actionable, LUS-anchored framework for decision-making in these high-risk neonatal populations [ 6, 13]. 2. Materials and Methods We conducted a structured narrative literature review of studies published from 2020 onward, examining the role of LUS and surfactant therapy in neonatal PTX and PH. Electronic databases including PubMed, Web of Science, Semantic Scholar, and Mendeley were systematically searched. The search strategy combined the following terms using Boolean operators: “lung ultrasound,” “neonatal POCUS,” “LUS score,” “surfactant therapy,” “neonatal pneumothorax,” “pulmonary hemorrhage in neonates,” “respiratory distress syndrome,” “minimally invasive surfactant administration,” and “LISA.” Although this is not a systematic review, selection was guided by PRISMA-inspired principles to enhance transparency and reproducibility ( Figure 1). The literature search was conducted between November 2025 and March 2026 and included studies published from 1 January 2000 to 30 March 2026; study selection and screening were independently performed by A.M.F., V.D., and S.D., with disagreements resolved through discussion. Studies were screened based on relevance to neonatal populations, clinical application of LUS and/or surfactant in PTX and PH, and quality of evidence. Original research articles, clinical trials, observational studies, national registry analyses, quality improvement projects, and high-quality reviews were included. Studies restricted to adult populations, non-clinical data, or unrelated outcomes were excluded. Priority was given to studies reporting quantitative LUS parameters, validated scoring systems, and patient-level outcome data. 3. Results The results are organized around five interconnected clinical domains: (3.1) lung ultrasound as a primary diagnostic tool in neonatal respiratory failure; (3.2) pulmonary hemorrhage—epidemiology, ultrasonographic features, and surfactant rationale; (3.3) pneumothorax—LUS-based diagnosis, risk stratification, and management; (3.4) pulmonary surfactant—biology, preparations, and dosing algorithms; and (3.5) LUS-guided surfactant strategies—scoring systems, administration techniques, and comorbidity impact. Across all domains, ultrasonographic phenotyping serves as the unifying clinical framework. 3.1. Lung Ultrasound as a Primary Imaging Tool in Neonatal Respiratory Failure Beyond the NICU, delivery room LUS has emerged as a powerful tool for early phenotyping of respiratory transition. A prospective monocentric study conducted in a Romanian tertiary referral center evaluated LUS patterns immediately after birth in term and near-term neonates. The study found that LUS aeration scores obtained within the first minutes of life accurately predicted subsequent respiratory support requirements, providing a clinically actionable framework for pre-emptive intervention—including early CPAP initiation or preparation for surfactant administration—before clinical deterioration occurs [ 9]. Table 1 summarizes the key LUS sonographic features relevant to the differential diagnosis of the most common neonatal respiratory conditions, including RDS, PH, PTX, TTN, and neonatal pneumonia, along with their respective LUS score implications and surfactant relevance. 3.2. Pulmonary Hemorrhage: Epidemiology, Ultrasonographic Phenotype, and Surfactant Rationale From an ultrasonographic perspective, PH generates distinctive and rapidly evolving LUS patterns that differ meaningfully from those of uncomplicated RDS, enabling bedside differentiation. The acute phase of PH is characterized by dense bilateral consolidation with a “tissue-like” echotexture, representing alveolar flooding with blood and proteinaceous fluid. Dynamic air bronchograms—mobile hyperechoic streaks within consolidated lung tissue—are often visible and reflect partial preservation of airway patency despite severe alveolar involvement. Shred signs, consisting of irregular, jagged deep margins to areas of consolidation, reflect the heterogeneous lung injury pattern. The pleural line becomes thick and irregular, and bilateral pleural effusions may be detectable. Crucially, B-lines in PH differ from those in RDS: they tend to be confluent, forming a “white lung” pattern bilaterally, and arise against a background of consolidated rather than simply atelectatic lung tissue [ 9, 13]. Serial LUS examination provides objective monitoring of treatment response following surfactant administration—a feature unavailable with conventional radiography. Restoration of lung aeration is reflected by progressive reduction in consolidation depth, fragmentation of previously dense echotexture, and reappearance of B-lines from previously consolidated zones. Complete or near-complete resolution of the white-lung pattern within 6–12 h of rescue surfactant is a favorable prognostic sign [ 9, 10]. However, no randomized controlled trial (RCT) has evaluated surfactant specifically in neonatal PH, and the absence of high-quality evidence limits definitive recommendations. Available data derive from retrospective series, observational studies, and expert consensus, all subject to substantial confounding by disease severity. A Cochrane review by Aziz and Ohlsson (2020) concluded that current evidence is insufficient to confirm or refute the efficacy of surfactant in neonatal PH, and called for prospective trials [ 25]. A multinational survey of 360 clinicians revealed highly variable management practices, with most using post-event surfactant administration alongside frequent hsPDA evaluation, but without standardized protocols [ 29]. 3.3. Pneumothorax: LUS-Based Diagnosis, Risk Stratification, and Therapeutic Sequencing Neonatal pneumothorax represents the pathological accumulation of free air in the pleural space and spans a clinical spectrum from asymptomatic, self-resolving forms to rapidly fatal tension PTX with cardiorespiratory collapse. Its multifactorial etiology encompasses the physiological stresses of birth transition, airway obstruction, underlying parenchymal lung disease (RDS, meconium aspiration syndrome, pneumonia), and iatrogenic barotrauma from invasive or non-invasive ventilatory support [ 34, 35]. Epidemiological data from a large multicenter cohort of approximately 58,700 infants documents an overall PTX prevalence of 0.53%, rising to 4.0% in infants born at 29–34 weeks and 4.6% in those ≤28 weeks. Most cases present within the first 24 h, particularly in infants ≥35 weeks (76%), where the physiological challenges of respiratory transition predominate. Delivery room respiratory interventions—CPAP initiation and endotracheal intubation—are stronger determinants of PTX risk than NICU-administered bubble CPAP, highlighting the importance of standardized delivery room protocols [ 34]. Incidence within the Swiss perinatal network ranged from 0.05% to 2%, reflecting significant inter-center variability in patient populations, diagnostic criteria, and management approaches [ 35]. 3.4. Pulmonary Surfactant: Biology, Preparations, and Clinical Pharmacology In the preterm lung, insufficient surfactant production and delayed secretion predispose to alveolar instability, progressive atelectasis, and ventilation-perfusion mismatch. Preservation of native surfactant function through lung-protective ventilation strategies is therefore a key determinant of respiratory outcome and underpins the rationale for non-invasive respiratory support [ 44]. Current evidence-based guidelines recommend early rescue surfactant administration in preterm infants with RDS rather than delayed treatment, with threshold FiO 2 values of approximately 0.30–0.50 on CPAP with PEEP ~7 cmH 2O representing pragmatic intervention triggers [ 26, 39, 49]. Table 2 summarizes the principal surfactant preparations in current clinical use, with their recommended dosing regimens, biological origins, and administration characteristics. 3.5. LUS-Guided Surfactant Strategies: Scoring, Administration Techniques, and Comorbidity Interactions In PTX, the therapeutic sequence is invariable: drainage precedes surfactant consideration. Once pleural air is evacuated and LUS confirms effective lung re-expansion, surfactant is indicated if LUS demonstrates residual RDS pattern (diffuse B-lines, bilateral consolidations) contributing to ongoing respiratory failure. Laryngeal mask airway (LMA)-mediated surfactant delivery has been reported in neonates with RDS and coexisting PTX as a strategy to avoid intubation and re-inflation pressures, though generalization of this approach requires further validation [ 43, 67]. Table 3 provides a comprehensive summary of the key clinical studies included in this review, detailing study characteristics, sample sizes, comorbidities, and main findings, offering a synthesized evidence matrix for clinical reference. 4. Discussion The clinical management of neonatal PH and PTX is evolving from a reactive, empirical discipline toward a proactive, ultrasonographically-informed precision medicine approach. The central argument of this review is that LUS is not merely a diagnostic adjunct in these conditions, but rather the primary decision architecture—the tool that defines when, whether, and how surfactant should be administered, and how the therapeutic response should be monitored. This reframing has significant implications for clinical protocol design, NICU infrastructure, and training priorities. The pathophysiological complexity underlying surfactant failure in PH and PTX is well characterized [ 23, 24, 25, 74, 75]. In PH, alveolar flooding with blood and plasma proteins irreversibly inactivates endogenous surfactant, dismantling the protective phospholipid film. Exogenous surfactant supplementation may transiently restore compliance and oxygenation, but only if administered after hemodynamic optimization—particularly ductal assessment and management—and only when LUS confirms a persistent consolidation-dominated phenotype amenable to surfactant-mediated re-aeration [ 25, 27, 28, 30]. The 2020 Cochrane review by Aziz and Ohlsson remains authoritative in acknowledging the biological plausibility of surfactant rescue in PH while simultaneously underscoring the absence of RCT evidence [ 25]. This evidence gap should motivate, not paralyze, clinical decision-making: when LUS demonstrates a white-lung pattern, physiological principles support a trial of rescue surfactant in a hemodynamically stable, coagulopathy-managed neonate. Table 4 summarizes the key take-home messages regarding the use of lung ultrasound (LUS) in neonatal intensive care practice, highlighting its diagnostic role, therapeutic implications, and practical impact on bedside decision. Prospective multicenter RCTs are urgently needed to define optimal surfactant indications, dosing, timing, and re-dosing criteria in neonatal PH, with LUS-based stratification as a foundational design element. For PTX, standardization of LUS-guided drainage protocols and post-PTX surfactant criteria across NICU networks would substantially reduce the inter-center variability currently documented in the literature. 5. Conclusions Neonatal pulmonary hemorrhage and pneumothorax represent acute, life-threatening complications in preterm and high-risk infants, characterized by high morbidity and mortality despite the significant advances of modern neonatal care. Exogenous surfactant therapy, firmly established as the cornerstone of RDS management, occupies an uncertain yet physiologically rational role in both PH and PTX, with current use guided by clinical judgment, pathophysiological principles, and—increasingly—ultrasonographic phenotyping. Lung ultrasound is the integrating tool that makes individualized surfactant decision-making feasible at the bedside. Validated quantitative LUS scoring systems provide reproducible, objective criteria for initial dosing and re-dosing that outperform empirical threshold-based approaches. Delivery room LUS enables pre-emptive identification of at-risk neonates; serial post-surfactant LUS enables real-time therapeutic monitoring. Nationally implemented LUS protocols demonstrate meaningful reductions in radiation exposure without clinical compromise. The ESPNIC consensus provides the evidence-based framework for POCUS integration into neonatal respiratory care. A LUS-anchored, physiology-driven algorithm—combining ultrasonographic phenotyping, hemodynamic assessment via functional echocardiography, and judicious application of minimally invasive surfactant techniques—represents the current best standard of care for these vulnerable populations. Standardization of POCUS training, protocol implementation, and inter-center benchmarking are the most pressing near-term priorities. Randomized controlled trials specifically designed around LUS-guided surfactant strategies in PH and PTX are the critical evidence gap that the neonatal community must urgently address. Author Contributions Conceptualization, A.M.F. and S.D.; methodology, E.T.; software, I.C. and A.S.M.; validation, S.D., M.D. and V.D.; formal analysis, A.M.F.; investigation, A.M.F. and P.V.; resources, F.F.; data curation, I.C.; writing—original draft preparation, A.M.F. and R.A.; writing—review and editing, F.F., V.D. and M.D.; visualization, R.A. and S.-I.J.-I.; supervision, A.S.M.; project administration, E.T.; funding acquisition, S.-I.J.-I. All authors have read and agreed to the published version of the manuscript. Funding This research received no external funding. Institutional Review Board Statement Not applicable. Informed Consent Statement Not applicable. Data Availability Statement No new data were created or analyzed in this study. Acknowledgments The authors used AI (Claude) for assistance in table generation and formatting during preparation. All content was critically reviewed and validated by authors. Conflicts of Interest The authors declare no conflicts of interest. Abbreviations The following abbreviations are used in this manuscript: AUC Area Under the Curve BPD Bronchopulmonary Dysplasia CPAP Continuous Positive Airway Pressure CRIB-II Clinical Risk Index for Babies II ELBW Extremely Low Birth Weight ESPNIC European Society of Paediatric and Neonatal Intensive Care FiO 2Fraction of Inspired Oxygen hsPDA Hemodynamically Significant Patent Ductus Arteriosus INSURE Intubate–Surfactant–Extubate LISA Less Invasive Surfactant Administration LMA Laryngeal Mask Airway LUS Lung Ultrasound MAS Meconium Aspiration Syndrome MIST Minimally Invasive Surfactant Therapy NICU Neonatal Intensive Care Unit PH Pulmonary Hemorrhage POCUS Point-Of-Care Ultrasound PPHN Persistent Pulmonary Hypertension of the Newborn PTX Pneumothorax RCT Randomized Controlled Trial RDS Respiratory Distress Syndrome SGA Small for Gestational Age TTN Transient Tachypnea of the Newborn VLBW Very Low Birth Weight References Ohuma, E.O.; Moller, A.-B.; Bradley, E.; Chakwera, S.; Hussain-Alkhateeb, L.; Lewin, A.; Okwaraji, Y.B.; Mahanani, R.W.; Johansson White, R.; Lavin, T.; et al. 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PRISMA flow diagram illustrating the study selection process for this narrative review. Databases searched: PubMed, Web of Science, Semantic Scholar, Mendeley. Total records identified: n = 1847 (databases) + 43 (other sources). After removal of duplicates, title/abstract screening, and full-text assessment for eligibility, 107 studies were included in the qualitative synthesis [ 14]. Figure 1. PRISMA flow diagram illustrating the study selection process for this narrative review. Databases searched: PubMed, Web of Science, Semantic Scholar, Mendeley. Total records identified: n = 1847 (databases) + 43 (other sources). After removal of duplicates, title/abstract screening, and full-text assessment for eligibility, 107 studies were included in the qualitative synthesis [ 14]. Table 1. Lung ultrasound (LUS) sonographic features in neonatal respiratory conditions: diagnostic differentiation and surfactant relevance. Table 1. Lung ultrasound (LUS) sonographic features in neonatal respiratory conditions: diagnostic differentiation and surfactant relevance. LUS Feature RDS Pulmonary Hemorrhage Pneumothorax TTN/Pneumonia Lung sliding Present Reduced/absent over consolidated zones Absent (pathognomonic) Present B-lines Diffuse, bilateral, homogeneous Diffuse, fused; alveolar flooding pattern Absent TTN: bilateral comet tails; Pneumonia: focal Consolidation Absent or minimal (atelectasis) Tissue-like; shred sign; dynamic air bronchograms Absent Pneumonia: subpleural/lobar consolidation Lung point Absent Absent Present (pathognomonic; guides thoracentesis) Absent Pleural line Irregular; subpleural consolidations Irregular, thickened; possible effusion No sliding; stratosphere sign (M-mode) TTN: regular; Pneumonia: focal irregularity LUS Score (0–18) ≥8: high surfactant need; ≤4: unlikely needed High (≥8–12); guides rescue surfactant timing N/A—diagnosis by absence of sliding/B-lines TTN: moderate; typically resolves without surfactant Surfactant implication Primary indication; LUS-guided dosing Rescue after hemodynamic stabilization; serial LUS monitoring Post-drainage; confirm RDS by LUS before dosing Generally not indicated Table 2. Dosing regimens, administration characteristics, and biological origin of commonly used surfactant preparations. Table 2. Dosing regimens, administration characteristics, and biological origin of commonly used surfactant preparations. Surfactant Origin Typical Dose (mg/kg) Number of Doses Day of Administration Table 3. Summary of key studies on surfactant therapy in neonatal pulmonary hemorrhage and pneumothorax: design, comorbidities, and principal findings. Table 3. Summary of key studies on surfactant therapy in neonatal pulmonary hemorrhage and pneumothorax: design, comorbidities, and principal findings. Authors [Ref] Year Country Study Design N Comorbidities Main Findings RDS: respiratory distress syndrome; PH: pulmonary hemorrhage; PTX: pneumothorax; CRIB-II: clinical risk index for babies II; CPAP-continuos positive airway pressure; hsPDA: hemodynamically significant patent ductus arteriosus; MAS: meconium aspiration syndrome; TTN: transient tachypnea of the newborn; NICU-neonatal intensive care unit; BPD: bronchopulmonary dysplasia; MIST: minimally invasive surfactant therapy; LISA: less invasive surfactant administration; LUS: lung ultrasound; AUC: area under the curve; N/A: not applicable; RCT: randomized controlled trial. Only a representative selection of included studies is shown. Table 4. Key Take-Home Messages for the Use of LUS in Neonatal Intensive Care Practice. Table 4. Key Take-Home Messages for the Use of LUS in Neonatal Intensive Care Practice. LUS Findings & Diagnostics Therapeutic Implications & Management Practical Clinical Impact 1. Ultrasound as First-Line (POCUS) Replaces conventional chest X-rays (CXR). Real-time, dynamic bedside evaluation. Eliminates diagnostic delays in the NICU. Allows for safe, serial follow-up scans. Reduces neonatal radiation exposure by >20% without compromising diagnostic accuracy or safety. 2. Quantitative LUS Score (0–18) Score 4: Good lung aeration. Score 8: Severe alveolar collapse or fluid flooding. Score 4: Excludes surfactant need. Score 8: Strongly indicates initial dosing or re-dosing. Replaces subjective decisions based on arbitrary FiO 2 thresholds. Excellent predictive accuracy (AUC 0.85–0.87). 3. Pulmonary Hemorrhage (PH) Reveals dense, “tissue-like” consolidations, shred sign, diffuse B-lines, and alveolar flooding patterns. Blood destroys endogenous surfactant. Rescue surfactant must be deferred until after hemodynamic stabilization and ductal (hsPDA) echo assessment. Prevents paradoxical worsening of left-to-right shunts while rapidly restoring surfactant film compliance. 4. Pneumothorax (PTX) Pathognomonic triad: absent lung sliding absent B-lines, and a visible lung point. Clinical sequence is strict: air drainage always precedes surfactant administration. Provides exact anatomical guidance for needle thoracentesis, avoiding blind punctures or waiting for a CXR. 5. Minimally Invasive Techniques Real-time tracking of lung re-aeration changes during non-invasive respiratory support. Strongly supports the use of LISA in spontaneously breathing infants. The LUS-LISA synergy minimizes mechanical ventilation exposure, intubation rates, and ventilator-induced lung injury. 6. Precision Neonatology Multimodal POCUS approach: lung ultrasound phenotyping with functional echocardiography. Allows for real-time individualization of airway pressure weaning based on objective structural responses. Mitigates severe hypoxic episodes and fluctuations in cerebral blood flow, protecting long-term neurodevelopment. Note: The structure and layout of this table were generated using AI. Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. Share and Cite MDPI and ACS Style Frenti, A.M.; Filip, F.; Tătăranu, E.; Dima, V.; Axinte, R.; Melinte, A.S.; Dima, M.; Ciubotariu, I.; Vicoveanu, P.; Jurchis-Irimie, S.-I.; et al. Lung Ultrasound-Guided Surfactant Therapy in Neonatal Pneumothorax and Pulmonary Hemorrhage: Pathophysiology, Diagnostic Ultrasonography, and Emerging Clinical Approaches. Children 2026, 13, 784. https://doi.org/10.3390/children13060784 AMA Style Frenti AM, Filip F, Tătăranu E, Dima V, Axinte R, Melinte AS, Dima M, Ciubotariu I, Vicoveanu P, Jurchis-Irimie S-I, et al. Lung Ultrasound-Guided Surfactant Therapy in Neonatal Pneumothorax and Pulmonary Hemorrhage: Pathophysiology, Diagnostic Ultrasonography, and Emerging Clinical Approaches. Children. 2026; 13(6):784. https://doi.org/10.3390/children13060784 Chicago/Turabian Style Frenti, Adina Mihaela, Florin Filip, Elena Tătăranu, Vlad Dima, Roxana Axinte, Alina Sânzâiana Melinte, Mirabela Dima, Iulia Ciubotariu, Petronela Vicoveanu, Smaranda-Ileana Jurchis-Irimie, and et al. 2026. "Lung Ultrasound-Guided Surfactant Therapy in Neonatal Pneumothorax and Pulmonary Hemorrhage: Pathophysiology, Diagnostic Ultrasonography, and Emerging Clinical Approaches" Children 13, no. 6: 784. https://doi.org/10.3390/children13060784 APA Style Frenti, A. M., Filip, F., Tătăranu, E., Dima, V., Axinte, R., Melinte, A. S., Dima, M., Ciubotariu, I., Vicoveanu, P., Jurchis-Irimie, S.-I., & Diaconescu, S. (2026). Lung Ultrasound-Guided Surfactant Therapy in Neonatal Pneumothorax and Pulmonary Hemorrhage: Pathophysiology, Diagnostic Ultrasonography, and Emerging Clinical Approaches. Children, 13(6), 784. https://doi.org/10.3390/children13060784 Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here. Article Metrics Article metric data becomes available approximately 24 hours after publication online.
