Lung ultrasound in the diagnosis and management of acute viral bronchiolitis; a systematic review

Abstract

Objective: Acute viral bronchiolitis (AVB) is one of the most common viral infections and the most common lower respiratory tract infection in the first year of life. Current guidelines recommend that medical history and physical examination have the main role in the diagnosis of AVB. Lung ultrasound (LUS) has not been included in the diagnostic algorithm so far. The aim of this systematic review is to collect all available studies concerning the role of LUS in the diagnosis and management of AVB. Methods: PubMed - MEDLINE, Scopus and ScienceDirect databases were searched for trials reporting on LUS examination in the diagnosis and management of AVB in paediatric patients. Results: A total of seventeen studies matching our eligibility criteria were analyzed for the purposes of this review and their results were categorized into six major fields each one of them answering to a question. There are several LUS scores that evaluate the severity of sonographic findings in children with AVB. The findings on LUS and chest radiography are comparable and LUS has a significant role in further management of AVB in the Paediatric Emergency Department. LUS score is correlated to the clinical course of AVB and it can predict both the duration of hospitalization and the need for respiratory support. Conclusion: Current literature supports that LUS could have comparable efficiency with chest radiography concerning the diagnosis of AVB and it could predict the length of hospital stay and the need of oxygen supply.