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312 suspicion of an ipsilateral diaphragmatic palsy. A radiograph of the chest revealed mildly elevated right hemidiaphragm without any fracture of the clavicle or humerus (Figure). A bedside ultrasound scan of the chest showed decreased movement of the right hemidiaphragm and normal movement on the left side with spontaneous respiration, confirming the diagnosis of right-sided diaphragmatic palsy (Video 1; available at www. jpeds. com). He was continued on respiratory support with mechanical ventilation, inotropic support, and other supportive measures and was rewarmed without any complications after 72 hours. As the neurologic status and activity improved, an extubation trial was performed on day 4, which the neonate could not tolerate. Conservative management was continued with serial monitoring for improvement of diaphragmatic excursion, and he was successfully extubated to high-flow nasal …