Riccardo Inchingolo1, Roberto Copetti2, Andrea Smargiassi3, Rafael Emanuele Gerardi3, Emanuele Giovanni Conte4, Giuseppe Maria Corbo3,5, Antonio Gatto6, Chiara Pierandrei5, Lavinia Capossela7, Ilaria Lazzareschi6,8, Piero Valentini6,8, Libertario Demi9. 1. Pulmonary Medicine Unit, UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli, 8, 00168, Rome, Italy. riccardo.inchingolo@policlinicogemelli.it. 2. Emergency Department, University Hospital Cattinara, Trieste, Italy. 3. Pulmonary Medicine Unit, UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli, 8, 00168, Rome, Italy. 4. Pulmonary Medicine Unit, Ospedale "C. E G. Mazzoni", Ascoli Piceno, Italy. 5. UOC Pneumologia, Università Cattolica del Sacro Cuore, Roma, Italy. 6. UOC Pediatria, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 7. School of Medicine and Surgery, Università Cattolica Sacro Cuore, Rome, Italy. 8. UOC Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy. 9. Ultrasound Laboratory Trento, Department of Information Engineering and Computer Science, University of Trento, Trento, Italy.
Abstract
AIMS: Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization. METHODS: Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted. RESULTS: Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008). CONCLUSIONS: USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: NCT03556488, June 14, 2018.
AIMS: Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization. METHODS:Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted. RESULTS: Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008). CONCLUSIONS: USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: NCT03556488, June 14, 2018.
Entities:
Keywords:
Air bronchogram; Children; Imaging; Pneumonia; Score; Ultrasound
Authors: Vito Antonio Caiulo; Luna Gargani; Silvana Caiulo; Andrea Fisicaro; Fulvio Moramarco; Giuseppe Latini; Eugenio Picano; Giuseppe Mele Journal: Pediatr Pulmonol Date: 2012-05-02
Authors: Yogen Singh; Cecile Tissot; María V Fraga; Nadya Yousef; Rafael Gonzalez Cortes; Jorge Lopez; Joan Sanchez-de-Toledo; Joe Brierley; Juan Mayordomo Colunga; Dusan Raffaj; Eduardo Da Cruz; Philippe Durand; Peter Kenderessy; Hans-Joerg Lang; Akira Nishisaki; Martin C Kneyber; Pierre Tissieres; Thomas W Conlon; Daniele De Luca Journal: Crit Care Date: 2020-02-24 Impact factor: 9.097