Maria Chiara Supino1, Danilo Buonsenso2, Simona Scateni3, Barbara Scialanga3, Maria Alessia Mesturino3, Caterina Bock4, Antonio Chiaretti2, Emanuele Giglioni3, Antonino Reale3, Anna Maria Musolino3. 1. Emergency Pediatric Department, Institute for Research and Health Care (IRCCS), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy. mariachiarasupino@gmail.com. 2. Department of Pediatrics, Institute for Research and Health Care (IRCCS), Fondazione Policlinico Universitario Gemelli, Largo Agostino Gemelli 8, 00168, Rome, Italy. 3. Emergency Pediatric Department, Institute for Research and Health Care (IRCCS), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy. 4. Department of Imaging, Institute for Research and Health Care (IRCCS), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
Abstract
Bronchiolitis is the most common cause of hospitalization of children in the first year of life. The lung ultrasound is a new diagnostic tool which is inexpensive, non-invasive, rapid, and easily repeatable. Our prospective study was conducted in the emergency department and all patients underwent a routine clinical evaluation and lung ultrasound by the pediatricians who defined the clinical and the ultrasound score. We enrolled 76 infants (median age 90 days [IQR 62-183], 53.9% males). In nasopharyngeal aspirates, the respiratory syncytial virus was isolated in 33 patients. Considering the clinical score, children with higher score had a higher probability of requiring respiratory support (p 0.001). At the ultrasound evaluation, there was a significant difference on ultrasound score between those who will need respiratory support or not (p 0.003). Infants who needed ventilation with helmet continuous positive airway pressure had a more severe ultrasound score (p 0.028) and clinical score (p 0.004), if compared with those who did not need it. Conclusion: Our study shows that lung ultrasound in the bronchiolitis may be a useful method to be integrated with the clinical evaluation to better define the prognosis of the individual patient. Multicenter studies on larger populations are necessary to confirm our data. What is Known: • Bronchiolitis is the main cause of lower respiratory tract infection in children younger than 24 months. • Ultrasound can evaluate the lung parenchyma without ionizing radiations. What is New: • Lung ultrasound may be a useful diagnostic tool to define the prognosis of the infants affected by bronchiolitis if performed at the first assessment in the emergency department. • The score obtained at the ultrasound evaluation is higher in those who will need oxygen therapy during admission for more time and in those who will need respiratory support with helmet continuous positive airway pressure.
Bronchiolitis is the most common cause of hospitalization of children in the first year of life. The lung ultrasound is a new diagnostic tool which is inexpensive, non-invasive, rapid, and easily repeatable. Our prospective study was conducted in the emergency department and all patients underwent a routine clinical evaluation and lung ultrasound by the pediatricians who defined the clinical and the ultrasound score. We enrolled 76 infants (median age 90 days [IQR 62-183], 53.9% males). In nasopharyngeal aspirates, the respiratory syncytial virus was isolated in 33 patients. Considering the clinical score, children with higher score had a higher probability of requiring respiratory support (p 0.001). At the ultrasound evaluation, there was a significant difference on ultrasound score between those who will need respiratory support or not (p 0.003). Infants who needed ventilation with helmet continuous positive airway pressure had a more severe ultrasound score (p 0.028) and clinical score (p 0.004), if compared with those who did not need it. Conclusion: Our study shows that lung ultrasound in the bronchiolitis may be a useful method to be integrated with the clinical evaluation to better define the prognosis of the individual patient. Multicenter studies on larger populations are necessary to confirm our data. What is Known: • Bronchiolitis is the main cause of lower respiratory tract infection in children younger than 24 months. • Ultrasound can evaluate the lung parenchyma without ionizing radiations. What is New: • Lung ultrasound may be a useful diagnostic tool to define the prognosis of the infants affected by bronchiolitis if performed at the first assessment in the emergency department. • The score obtained at the ultrasound evaluation is higher in those who will need oxygen therapy during admission for more time and in those who will need respiratory support with helmet continuous positive airway pressure.
Authors: John Henderson; Tom N Hilliard; Andrea Sherriff; Deborah Stalker; Nufoud Al Shammari; Huw M Thomas Journal: Pediatr Allergy Immunol Date: 2005-08 Impact factor: 6.377
Authors: Kohei Hasegawa; Yusuke Tsugawa; David F M Brown; Jonathan M Mansbach; Carlos A Camargo Journal: Pediatrics Date: 2013-06-03 Impact factor: 7.124
Authors: E Kathryn Miller; Tebeb Gebretsadik; Kecia N Carroll; William D Dupont; Yassir A Mohamed; Laura-Lee Morin; Luke Heil; Patricia A Minton; Kimberly Woodward; Zhouwen Liu; Tina V Hartert; John V Williams Journal: Pediatr Infect Dis J Date: 2013-09 Impact factor: 2.129
Authors: Jonathan M Mansbach; Alexander J McAdam; Sunday Clark; Paul D Hain; Robert G Flood; Uchechi Acholonu; Carlos A Camargo Journal: Acad Emerg Med Date: 2008-02 Impact factor: 3.451
Authors: Sara Bobillo-Perez; Clara Sorribes; Paula Gebellí; Nuria Lledó; Marta Castilla; Miquel Ramon; Javier Rodriguez-Fanjul Journal: Eur J Pediatr Date: 2021-02-13 Impact factor: 3.183
Authors: Ryan L DeSanti; Eileen A Cowan; Pierre D Kory; Michael R Lasarev; Jessica Schmidt; Awni M Al-Subu Journal: J Ultrasound Med Date: 2021-08-11 Impact factor: 2.754
Authors: Carmina Guitart; Esther Esteban; Judit Becerra; Javier Rodríguez-Fanjul; Francisco José Cambra; Mònica Balaguer; Iolanda Jordan Journal: Pediatr Res Date: 2021-12-30 Impact factor: 3.953
Authors: Antonio Di Mauro; Anna Rita Cappiello; Angela Ammirabile; Nicla Abbondanza; Francesco Paolo Bianchi; Silvio Tafuri; Mariano M Manzionna Journal: Medicina (Kaunas) Date: 2020-06-26 Impact factor: 2.430
Authors: Anna Maria Musolino; Maria Chiara Supino; Danilo Buonsenso; Valentina Ferro; Piero Valentini; Andrea Magistrelli; Mary Haywood Lombardi; Lorenza Romani; Patrizia D'Argenio; Andrea Campana Journal: Ultrasound Med Biol Date: 2020-05-03 Impact factor: 2.998
Authors: Joanna Jaworska; Anna Komorowska-Piotrowska; Andrzej Pomiećko; Jakub Wiśniewski; Mariusz Woźniak; Błażej Littwin; Magdalena Kryger; Piotr Kwaśniewicz; Józef Szczyrski; Katarzyna Kulińska-Szukalska; Natalia Buda; Zbigniew Doniec; Wojciech Kosiak Journal: Diagnostics (Basel) Date: 2020-11-11