Danilo Buonsenso1,2,3, Cristina De Rose1, Valentina Ferro4, Rosa Morello1, Annamaria Musolino4, Piero Valentini1. 1. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy. 2. Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy. 3. Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy. 4. Department of Pediatric Emergency Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Abstract
OBJECTIVE AND DESIGN: Our prospective observational study is the first study that evaluates the lung ultrasound (LUS) findings of cardiopulmonary interactions in acutely ill children with elevated pro-brain natriuretic peptide (BNP) levels, with the aim of establishing the specific LUS pattern in this category of patients without primary lung diseases. METHODOLOGY: We prospectively analyzed epidemiological, clinical, laboratory, instrumental, and lung ultrasound parameters in acutely ill children aged 1 month to 18 years admitted to the Department of Pediatrics between March 2020 to August 2020. Among the acutely ill patients evaluated, only patients with pro-BNP > 300 pg/ml and who underwent LUS before the start of any treatment were included. They were stratified into three subcategories based on the diagnosis (A) cardiac disease, (B) systemic inflammatory disease/sepsis without functional and/or organic alterations of the myocardium, and (C) systemic inflammatory disease/sepsis and cardiac disease, and were classified into two groups based on the level of pro-BNP. We also enrolled patients belonging to two other categories (patients with primary infectious lung disease and completely healthy patients) analyzing their epidemiological, clinical, laboratory, instrumental parameters, and lung ultrasound findings and comparing them with those of acutely ill children. RESULTS AND CONCLUSION: We found that LUS findings in these acutely ill children are different from the ultrasound pattern of other categories of children and in particular (1) children with acute lower respiratory tract infections and (2) healthy infants. The finding in a child of a sonographic interstitial syndrome with multiple, bright, long, separate, and nonconfluent B-lines/long vertical artifacts deriving from a normal and regular pleural line, in the absence of subpleural consolidations, is strongly predictive of cardiogenic pulmonary edema or pulmonary congestion in the course of systemic inflammatory disease/sepsis.
OBJECTIVE AND DESIGN: Our prospective observational study is the first study that evaluates the lung ultrasound (LUS) findings of cardiopulmonary interactions in acutely ill children with elevated pro-brain natriuretic peptide (BNP) levels, with the aim of establishing the specific LUS pattern in this category of patients without primary lung diseases. METHODOLOGY: We prospectively analyzed epidemiological, clinical, laboratory, instrumental, and lung ultrasound parameters in acutely ill children aged 1 month to 18 years admitted to the Department of Pediatrics between March 2020 to August 2020. Among the acutely ill patients evaluated, only patients with pro-BNP > 300 pg/ml and who underwent LUS before the start of any treatment were included. They were stratified into three subcategories based on the diagnosis (A) cardiac disease, (B) systemic inflammatory disease/sepsis without functional and/or organic alterations of the myocardium, and (C) systemic inflammatory disease/sepsis and cardiac disease, and were classified into two groups based on the level of pro-BNP. We also enrolled patients belonging to two other categories (patients with primary infectious lung disease and completely healthy patients) analyzing their epidemiological, clinical, laboratory, instrumental parameters, and lung ultrasound findings and comparing them with those of acutely ill children. RESULTS AND CONCLUSION: We found that LUS findings in these acutely ill children are different from the ultrasound pattern of other categories of children and in particular (1) children with acute lower respiratory tract infections and (2) healthy infants. The finding in a child of a sonographic interstitial syndrome with multiple, bright, long, separate, and nonconfluent B-lines/long vertical artifacts deriving from a normal and regular pleural line, in the absence of subpleural consolidations, is strongly predictive of cardiogenic pulmonary edema or pulmonary congestion in the course of systemic inflammatory disease/sepsis.
Authors: Moises Rodriguez-Gonzalez; Patricia Rodriguez-Campoy; Ana Estalella-Mendoza; Ana Castellano-Martinez; Jose Carlos Flores-Gonzalez Journal: Tomography Date: 2022-01-05
Authors: Anna Maria Musolino; Elena Boccuzzi; Danilo Buonsenso; Maria Chiara Supino; Maria Alessia Mesturino; Eugenio Pitaro; Valentina Ferro; Raffaella Nacca; Serena Sinibaldi; Paolo Palma; Alberto Villani; Paolo Tomà Journal: J Clin Med Date: 2022-01-01 Impact factor: 4.241
Authors: Anna Camporesi; Marco Gemma; Danilo Buonsenso; Stefania Ferrario; Anna Mandelli; Matteo Pessina; Veronica Diotto; Elena Rota; Irene Raso; Laura Fiori; Alessandro Campari; Francesca Izzo Journal: Children (Basel) Date: 2022-06-21