Characterizing pediatric lung ultrasound findings during a chemically induced bronchospasm

Gagnon, François; Marzook, Noah; Déragon, Alexandre; Lands, Larry C.; Zielinski, David; Shapiro, Adam J.; Rampakakis, Emmanouil; Dubrovsky, Alexander Sasha

doi:10.1002/ppul.25907

Cited by 3 publications

(1 citation statement)

References 40 publications

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“…For optimal comparison, further investigation is needed to understand baseline lung ultrasounds in healthy children. Similarly, Gagnon et al 4 sought to describe lung ultrasound findings after a chemically induced bronchospasm. In this prospective study, children ages 6–17 years were recruited from patients referred for methacholine challenge testing.…”

Section: Diagnosis and Evaluationmentioning

confidence: 99%

Pediatric pulmonology 2022 year in review: Asthma

Stephenson,

Espaillat,

Loughlin

2023

Pediatric Pulmonology

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In 2022, new research studies influenced the field of pediatric asthma with improvements in diagnosis and evaluation; new treatment options including biologic therapies; changes in risk factors for asthma; and increased discussion about the impact of social determinants of health on asthma. Additionally, three years after the start of the COVID‐19 pandemic, we continue to see the impact of SARS‐CoV‐2 virus on pediatric asthma care. In this review article, we summarize the significant findings from publications in Pediatric Pulmonology and other relevant journals from the last year. We hope this review will provide new insight within the field of pediatric asthma, as well as guidance for implementation into clinical practice.

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Section: Diagnosis and Evaluationmentioning

confidence: 99%

Pediatric pulmonology 2022 year in review: Asthma

Stephenson,

Espaillat,

Loughlin

2023

Pediatric Pulmonology

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Lung Ultrasound Findings in Children With Asthma Exacerbations

Hoffmann,

Neuman,

et al. 2024

J of Ultrasound Medicine

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ObjectiveWe sought to assess whether the presence and extent of lung ultrasound (LUS) findings were associated with asthma exacerbation severity in children.MethodsWe enrolled a convenience sample of patients aged 5–18 years presenting with acute asthma exacerbation to a tertiary care pediatric emergency department. Severity of an asthma exacerbation (mild, moderate, severe) was assessed within 1 hour of the LUS using the Hospital Asthma Severity Score, a validated asthma assessment tool. LUS was performed by trained pediatric emergency providers. The presence of LUS findings (B‐lines, consolidations, pleural effusion, and pleural line abnormalities) was assessed using a standardized criterion based on consensus guidelines.ResultsA total of 111 patients with a median age of 8 years (interquartile range 6–12) were enrolled. LUS was positive in 57% of patients. Pleural line abnormalities were observed in 34%, B‐lines in 29%, consolidations <1 cm in 24%, and consolidations ≥1 cm in 7%. Patients with moderate and severe asthma exacerbations were more likely to have any B‐lines (31% and 43%, respectively) than patients with mild exacerbations (12%; P = .021); however, the presence of ≥3 B‐lines or confluent B‐lines did not differ across severity groups. The presence of other findings did not differ based on asthma severity.ConclusionsLUS findings are observed in a substantial portion of children presenting with asthma exacerbations. B‐lines were the only LUS finding significantly associated with asthma severity, while lung consolidations <1 cm and >1 cm were not correlated with severity. These findings provide valuable information for the diagnostic use of LUS in pediatric patients with asthma exacerbation.

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Lung ultrasound in children with primary ciliary dyskinesia or cystic fibrosis

Marzook,

Dubrovsky,

Muchantef

et al. 2024

Pediatric Pulmonology

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IntroductionPrimary ciliary dyskinesia (PCD) and cystic fibrosis (CF) are respiratory conditions requiring regular chest radiography (CXR) surveillance to monitor pulmonary disease. However, CXR is insensitive for lung disease in CF and PCD. Lung ultrasound (LU) is a radiation‐free alternative showing good correlation with severity of lung disease in CF but has not been studied in PCD.MethodStandardized, six‐zone LU studies and CXR were performed on a convenience sample of children with PCD or CF during a single visit when well. LU studies were graded using the LU scoring system, while CXR studies received a modified Chrispin‐Norman score. Scores were correlated with clinical outcomes.ResultData from 30 patients with PCD and 30 with CF (median age PCD 11.5 years, CF 9.1 years) with overall mild pulmonary disease (PCD median FEV1 90% predicted, CF FEV1 100%) were analyzed. LU abnormalities appear in 11/30 (36%) patients with PCD and 9/30 (30%) with CF. Sensitivity, specificity, positive predictive, and negative predictive values for abnormal LU compared to the gold standard of CXR are 42%, 61%, 42%, and 61% in PCD, and 44%, 81%, 50%, and 77% in CF, respectively. Correlation between LU and CXR scores are poor for both diseases (PCD r = −0.1288, p = 0.4977; CF r = 0.0343, p = 0.8571), and LU score does not correlate with clinical outcomes in PCD.ConclusionThe correlation of LU findings with CXR surveillance studies is poor in patients with mild disease burdens from PCD or CF, and LU scores do not correlate with clinical outcomes in PCD.

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Characterizing pediatric lung ultrasound findings during a chemically induced bronchospasm

Cited by 3 publications

References 40 publications

Pediatric pulmonology 2022 year in review: Asthma

Pediatric pulmonology 2022 year in review: Asthma

Lung Ultrasound Findings in Children With Asthma Exacerbations

Lung ultrasound in children with primary ciliary dyskinesia or cystic fibrosis

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