Background and aims Meconium aspiration syndrome (MAS) is a rare and life-threatening neonatal lung injury induced by meconium in the lung and airways. Lung ultrasound (LUS) is a quick, easy and cheap imaging technique that is increasingly used in critical care settings. Specific LUS findings have been described for some types of neonatal lung injury, but no formal data exists on ultrasound imaging of MAS. We here describe ultrasound findings in MAS. Methods Five patients with MAS of variable severity were examined by LUS during the first hours of life, using either a microconvex 7,5 MHz, or a linear 12-18 MHz probe. Chest Xrays were used as reference. Results A range of unevenly distributed dynamic signs was observed in five neonates with MAS (LUS dynamic video recordings will be shown). The following signs were seen in all cases: 1) B-pattern (interstitial) coalescent or sparse; 2) consolidations; 3) atelectasis; 4) bronchograms. No pattern was observed for distribution of signs in lung areas. The signs in the same lung area varied with time, reflecting the changing auscultation patterns. In our opinion, this is due to the changing localisation of meconium and the displacement or dissolution of meconium plugs. LUS images corresponded well with X-ray findings. Conclusions We provide the first formal description of LUS findings in neonates with MAS. LUS seems to be a useful and promising tool in the diagnosis and management of MAS, providing real-time bedside imaging, with the additional potential benefit of limiting radiation exposure in sick neonates.

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