Mercedes Bueno-Campaña1, Talía Sainz2,3, Maria Alba1, Teresa Del Rosal2,3, Ana Mendez-Echevarría2,3, Regina Echevarria1, Alfredo Tagarro3,4,5, Marta Ruperez-Lucas1, Maria L Herrreros4, Libertad Latorre4, Cristina Calvo2,3,6. 1. Department of Pediatrics and Neonatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain. 2. Department of Pediatrics, Tropical and Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain. 3. Translational Research Network for Pediatric Infectious Diseases (RITIP), Madrid, Spain. 4. Department of Pediatrics, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain. 5. Universidad Europea de Madrid, Madrid, Spain. 6. TEDDY Network Member (European Network of Excellence for Pediatric Clinical Research), Bari, Italy.
Abstract
OBJECTIVE: Respiratory tract infections are among the most common causes of morbidity and mortality worldwide. Acute bronchiolitis (AB) is the leading cause of hospital admission among infants. Clinical scores have proven to be inaccurate in predicting prognosis. Our aim was to build a score based on findings of lung ultrasound (LU) performed at admission, to stratify patients at risk of needing respiratory support (non-invasive and invasive ventilation). STUDY DESIGN: Prospective, multicenter study including infants <6 months of age admitted with AB. Point-of-care LU was performed on admission, and a score was calculated based on ultrasound findings (presence and localization of B lines, B line confluence and/or consolidations) and clinical data. Main outcome was need of respiratory support. RESULTS: A total of 145 patients were included in the study, with a median age of 1.7 months [IQR: 1.2-2.8], 47.6% were female. Mean duration of symptoms prior to admission was 3.1 days (SD 1.8). Fifty-six patients (39%) required non-invasive ventilation (NIV), 14 (9.7%) were transferred to PICU, and 3 needed invasive ventilation (3/145). Identification of at least one posterior consolidation >1 cm was the main factor associated to NIV (RR 4.4; [CI95%1.8-10.8]) The LU score built according to the findings on admission showed an AUC: 0.845(CI95%:0.78-0.91). A score ≥3.5 showed a sensitivity of 89.1% (CI95%:78.2-94.9%) and specificity of 56% (CI95%: 45.3-66.1%) CONCLUSIONS: Among infants below 6 months of age admitted with AB, point-of-care LU was a helpful tool to identify patients at risk of needing respiratory support.
OBJECTIVE:Respiratory tract infections are among the most common causes of morbidity and mortality worldwide. Acute bronchiolitis (AB) is the leading cause of hospital admission among infants. Clinical scores have proven to be inaccurate in predicting prognosis. Our aim was to build a score based on findings of lung ultrasound (LU) performed at admission, to stratify patients at risk of needing respiratory support (non-invasive and invasive ventilation). STUDY DESIGN: Prospective, multicenter study including infants <6 months of age admitted with AB. Point-of-care LU was performed on admission, and a score was calculated based on ultrasound findings (presence and localization of B lines, B line confluence and/or consolidations) and clinical data. Main outcome was need of respiratory support. RESULTS: A total of 145 patients were included in the study, with a median age of 1.7 months [IQR: 1.2-2.8], 47.6% were female. Mean duration of symptoms prior to admission was 3.1 days (SD 1.8). Fifty-six patients (39%) required non-invasive ventilation (NIV), 14 (9.7%) were transferred to PICU, and 3 needed invasive ventilation (3/145). Identification of at least one posterior consolidation >1 cm was the main factor associated to NIV (RR 4.4; [CI95%1.8-10.8]) The LU score built according to the findings on admission showed an AUC: 0.845(CI95%:0.78-0.91). A score ≥3.5 showed a sensitivity of 89.1% (CI95%:78.2-94.9%) and specificity of 56% (CI95%: 45.3-66.1%) CONCLUSIONS: Among infants below 6 months of age admitted with AB, point-of-care LU was a helpful tool to identify patients at risk of needing respiratory support.
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: 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: 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
Authors: Moises Rodriguez-Gonzalez; Patricia Rodriguez-Campoy; Ana Estalella-Mendoza; Ana Castellano-Martinez; Jose Carlos Flores-Gonzalez Journal: Tomography Date: 2022-01-05
Authors: Laura Gori; Antonella Amendolea; Danilo Buonsenso; Stefano Salvadori; Maria Chiara Supino; Anna Maria Musolino; Paolo Adamoli; Alfina Domenica Coco; Gian Luca Trobia; Carlotta Biagi; Marco Lucherini; Alberto Leonardi; Giuseppe Limoli; Matteo Giampietri; Tiziana Virginia Sciacca; Rosa Morello; Francesco Tursi; Gino Soldati Journal: J Clin Med Date: 2022-07-21 Impact factor: 4.964