Pleura-ABCDE - a structured expert-based protocol for neonatal lung ultrasound documentation and interpretation

BACKGROUND: Neonatal lung ultrasound is a rapidly emerging imaging modality with increasing impact, but lacks standardized protocols and curricula, resulting in inconsistent dissemination and quality assurance.

RESULTS: We present a structured protocol for documentation and interpretation of lung ultrasound. For each lung region, the acronym Pleura-ABCDE is used to analyze the pleura (sliding, morphology), A-Lines, B-Lines, Consolidation, Dynamics (lung point, double lung point) and Effusion. The structured documentation and interpretation could provide clues to differentiate respiratory diseases in newborns.

CONCLUSION: The Pleura-ABCDE protocol provides structured documentation and interpretation support for lung ultrasound in neonates. In contrast to flowchart-based protocols, a pattern-based approach and link to clinical presentation allows an integrative perspective on the use of neonatal lung ultrasound. Therefore, with this expert-based proposal, we aim to improve documentation and thereby support diagnostic quality and reproducibility, as recommended by international ultrasound societies.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13089-025-00442-4.