Lung Ultrasound Guided Choice of Best Positive End-Expiratory Pressure in Neonatal Anesthesia

This study investigates whether lung ultrasound — a bedside, radiation-free imaging tool — can guide the optimal setting of ventilator pressure (PEEP, or Positive End-Expiratory Pressure) during general anaesthesia for newborns and very young infants. Babies' lungs are particularly sensitive to collapse and over-inflation during surgery, and finding the right pressure balance is critical for preventing lung injury. Lung ultrasound can detect areas of collapsed or over-expanded lung in real time, potentially allowing more personalised and safer ventilation. Infants born after 33 weeks of pregnancy and up to 50 weeks of post-conceptional age who require elective or urgent surgery under general anaesthesia with a breathing tube are eligible. Babies born before 33 weeks, those with known heart or lung abnormalities, immune or metabolic diseases, or whose parents have not consented are excluded. During the procedure, lung ultrasound is performed alongside standard ventilator monitoring to guide PEEP adjustments. The study observes outcomes without introducing any extra invasive steps. This research is important because newborns are a uniquely vulnerable population during anaesthesia, and even small improvements in ventilation management can reduce the risk of post-operative lung complications and intensive care admissions.