Acute Bronchiolitis: Is There a Role for Lung Ultrasound?

Mauro, Antônio Orlando Di; Ammirabile, Angela; Quercia, Michele; Panza, Raffaella; Capozza, Manuela; Manzionna, Mariano; Laforgia, Nicola

doi:10.3390/diagnostics9040172

Cited by 26 publications

(27 citation statements)

References 20 publications

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“…In this regard, a review evaluated the role of LUS in infants with bronchiolitis. 30 Eight studies were included, and the most common findings ranged from alveolar-interstitial syndrome (confluent vertical artifacts) in mild-to-moderate cases, to subpleural consolidations, areas of white lung, pleural line anomalies, and pleural effusions in the most severe ones. However, as described in our study, the presence of multiple lung artifacts (currently described as alveolar interstitial syndrome) should not reflexively be interpreted as a pathologic finding in this age group, given the prevalence of these findings in otherwise healthy infants, whereas pleural abnormalities, consolidations, and effusion were not noted in healthy infants and remain indicative of a pathologic condition.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have demonstrated its usefulness in the diagnosis and follow‐up of community‐acquired pneumonia 27,28 and, in particular, bronchiolitis, 5,29 one of the most common reasons for the seeking of medical care for infants in the first year of life. In this regard, a review evaluated the role of LUS in infants with bronchiolitis 30 . Eight studies were included, and the most common findings ranged from alveolar‐interstitial syndrome (confluent vertical artifacts) in mild‐to‐moderate cases, to subpleural consolidations, areas of white lung, pleural line anomalies, and pleural effusions in the most severe ones.…”

Section: Discussionmentioning

confidence: 99%

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Lung Ultrasound Pattern in Healthy Infants During the First 6 Months of Life

Buonsenso

Soldati

Curatola

et al. 2020

J of Ultrasound Medicine

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Objectives-Lung ultrasound (LUS) has gained a primary role in the diagnosis and management of pleuropulmonary disorders in pediatric practice. However, normal and pathologic patterns are translated from adult studies and have never been specifically studied in children, particularly in infants. This was a prospective observational pilot study aiming to define the normal LUS pattern in healthy infants during the first 6 months of life. Methods-We recruited healthy neonates at 7 to 10 days of life, and these were followed until the sixth month of life (times: 7-10 days, 1 month, 3 months, and 6 months). We excluded neonates with a gestational age before 33 weeks and neonates with cardiac or lung abnormalities or diseases, immune deficiencies, metabolic or genetic conditions, and acute or chronic respiratory diseases. A LUS evaluation was performed by a single certified pediatrician. The chest wall was examined in 18 areas, addressing A-lines, short and long B-lines, pleural abnormalities, and subpleural consolidations. Results-Thirty-seven neonates were enrolled and followed until the sixth month of life, 27 (73%) of whom were born at term (≥37 weeks) and 10 (27%) of whom were born preterm (33-36 weeks). Most of the patients at 7 to 10 days showed multiple B-lines (long and short) with a progressive normalization toward a normal A pattern at 6 months (P < .00001; 95% confidence interval, 13.75-23.24). No infants showed subpleural consolidations or pleural abnormalities. Conclusions-This study has implications for the interpretation of LUS during the first 6 months of life. Most healthy infants show a diffuse pattern of vertical artifacts (B-lines), and the LUS pattern tends to be similar to the physiologic pattern (A-lines) after the sixth month of life. The only pathologic LUS findings were pleural irregularities and effusion and subpleural consolidations, which have never been described in healthy infants.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound Pattern in Healthy Infants During the First 6 Months of Life

Buonsenso

Soldati

Curatola

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…Similarly, Jaszczolt et al point out the utility of LUS in comparison with CXR, considering the main advantages of sonographic imaging: absence of radiations, short time of examination, higher sensitivity in the evaluation of pleural effusion, small consolidations and signs of interstitial involvement in patients with bronchiolitis [ 14 ]. In recent decades, many studies suggested that LUS findings in children with bronchiolitis correlate with disease severity [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound and Clinical Progression of Acute Bronchiolitis: A Prospective Observational Single-Center Study

et al. 2020

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Background and Objectives: Recent literature suggests that lung ultrasound might have a role in the diagnosis and management of bronchiolitis. The aim of the study is to evaluate the relationship between an ultrasound score and the clinical progression of bronchiolitis: need for supplemental oxygen, duration of oxygen therapy and hospital stay. Materials and Methods: This was a prospective observational single-center study, conducted in a pediatric unit during the 2017–2018 epidemic periods. All consecutive patients admitted with clinical signs of acute bronchiolitis, but without the need for supplemental oxygen, underwent a lung ultrasound in the first 24 h of hospital care. The lung involvement was graded based on the ultrasound score. During clinical progression, need for supplemental oxygen, duration of oxygen therapy and duration of hospital stay were recorded. Results: The final analysis included 83 patients, with a mean age of 4.5 ± 4.1 months. The lung ultrasound score in patients that required supplemental oxygen during hospitalization was 4.5 ± 1.7 (range: 2.0–8.0), different from the one of the not supplemented infants (2.5 ± 1.8; range: 0.0–6.0; p < 0.001). Ultrasound score was associated with the need for supplemental oxygen (OR = 2.2; 95% CI = 1.5–3.3; p < 0.0001). Duration of oxygen therapy was not associated with LUS score (p > 0.05). Length of hospital stay (coef. = 0.5; 95% CI = 0.2–0.7; p < 0.0001) correlates with LUS score. Conclusion: Lung ultrasound score correlates with the need of supplemental oxygen and length of hospital stay in infants with acute bronchiolitis.

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“…72,73 Currently, LUS is not routinely used in the assessment of children with suspected bronchiolitis. [9][10][11]37,38,74 Though often relatively small, the available studies on LUS in cases of bronchiolitis demonstrate common findings include focal or confluent B-lines, subpleural consolidations of variable sizes (with or without air bronchograms), and an irregular pleural line. 10,11 The presence of LUS findings typically increase with a higher disease severity, and LUS has been shown to predict the need for respiratory support.…”

Section: Bronchiolitismentioning

confidence: 99%

<p>Lung Ultrasound in Children with Respiratory Tract Infections: Viral, Bacterial or COVID-19? A Narrative Review</p>

Kharasch¹,

Duggan²,

Cohen³

et al. 2020

OAEM

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Respiratory tract infections (RTIs) are common complaints among patients presenting to the pediatric emergency department. In the diagnostic assessment of children with RTIs, many patients ultimately undergo imaging studies for further evaluation. Point-ofcare lung ultrasound (LUS) can be used safely and with a high degree of accuracy in differentiating etiologies of RTIs in pediatric patients. Ultrasonographical features such as an irregular pleural line, subpleural consolidations, focal and lobar consolidation and signs of interstitial involvement can be used to distinguish between several pathologies. This work offers a comprehensive overview of pediatric LUS in cases of the most common pediatric RTIs including bacterial and viral pneumonia, bronchiolitis, and COVID-19.

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Acute Bronchiolitis: Is There a Role for Lung Ultrasound?

Cited by 26 publications

References 20 publications

Lung Ultrasound Pattern in Healthy Infants During the First 6 Months of Life

Lung Ultrasound Pattern in Healthy Infants During the First 6 Months of Life

Lung Ultrasound and Clinical Progression of Acute Bronchiolitis: A Prospective Observational Single-Center Study

<p>Lung Ultrasound in Children with Respiratory Tract Infections: Viral, Bacterial or COVID-19? A Narrative Review</p>

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