Lung ultrasound systematic review shows its prognostic and diagnostic role in acute viral bronchiolitis

Kogias, Christos; Prountzos, Spyridon; Alexopoulou, Efthymia; Douros, Konstantinos

doi:10.1111/apa.16578

Cited by 6 publications

(8 citation statements)

References 51 publications

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“…Conversely, our data confirm the utility of lung ultrasound in the evaluation of infants with bronchiolitis and support the hypothesis that the LUS score, evaluated on admission, can identify those patients who will need respiratory support, as previously reported by different studies (25). In particular, a LUS score above 8 could identify infants who will need respiratory support, whereas we found a higher score (>13) in those who underwent mechanical ventilation.…”

Section: Patients (N = 60)supporting

confidence: 91%

Are lung ultrasound features more severe in infants with bronchiolitis and coinfections?

De Rose,

Maddaloni,

Martini

et al. 2023

Front. Pediatr.

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BackgroundThe lung ultrasound (LUS) score can be a useful tool to predict the need for respiratory support and the length of hospital stay in infants with bronchiolitis.ObjectiveTo compare lung ultrasound features in neonates and infants up to three months of age with bronchiolitis to determine whether LUS scores (range 0–36) differ in infants with coinfections or not.MethodsNeonates and infants younger than three months admitted to neonatal units from October 2022 to March 2023, who underwent lung ultrasound evaluation on admission, were included in this retrospective study.ResultsWe included 60 patients who underwent LUS evaluation at admission. Forty-two infants (70.0%) had a single viral infection. Eighteen infants (30.0%) had a coinfection: fifteen infants (25.0%) had more than one virus at PCR; one infant (1.7%) had both a viral coinfection and a viral-bacteria coinfection; two infants (3.3%) had viral-bacteria coinfection. Infants with a single viral infection and those with coinfections had similar LUS scores globally and in different lung zones. An LUS score higher than 8 was identified to significantly predict the need for any respiratory support (p = 0.0035), whereas an LUS score higher than 13 was identified to significantly predict the need for mechanical ventilation (p = 0.024).ConclusionIn our small cohort of neonates and infants younger than three months hospitalized with bronchiolitis, we found no statistically significant differences in the LUS score on admission between patients with a single viral infection and those with multiple infections.

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Section: Patients (N = 60)supporting

confidence: 91%

Are lung ultrasound features more severe in infants with bronchiolitis and coinfections?

De Rose,

Maddaloni,

Martini

et al. 2023

Front. Pediatr.

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show abstract

“…In other words, incorporating lung ultrasound in the assessment of patients with bronchiolitis could enhance their evaluation and increase confidence in safely discharging patients who are considered to be at a lower risk. The early identification of high-risk patients would significantly contribute to improved hospital management, facilitate decision making regarding patient admission, and allow for the timely and accurate administration of respiratory supportive treatment [20,21].…”

Section: Discussionmentioning

confidence: 99%

“…This facilitates comprehensive pathogenic progression monitoring, empowering the creation of customised treatment plans for each individual patient. With the increasing availability of new portable devices, point-of-care lung ultrasound is becoming more widely used in emergency departments, where clinical examination and this technique may complement each other in the assessment of patients with acute respiratory distress, making it an encouraging tool for clinical practice [21].…”

Section: Application and Recommendationsmentioning

confidence: 99%

Lung Ultrasound: A Useful Prognostic Tool in the Management of Bronchiolitis in the Emergency Department

Hernández-Villarroel,

Ruiz-García,

Manzanaro

et al. 2023

JPM

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Lung ultrasound, a non-invasive bedside technique for assessing paediatric patients with acute respiratory diseases, is becoming increasingly widespread. The aim of this prospective, observational cohort study was to evaluate the effectiveness of a clinical ultrasound score in assessing infants with acute bronchiolitis in the emergency department and its ability to accurately identify patients at a higher risk of clinical deterioration. Infants under 6 months of age with clinical symptoms compatible with acute bronchiolitis were enrolled and underwent clinical and lung ultrasound evaluations. The study included 50 patients, the median age of which was 2.2 months (IQR: 1–5), and the primary outcome was respiratory support. Infants requiring invasive or non-invasive ventilation showed higher scores (5 points [IQR: 3.5–5.5] vs. 2.5 [IQR: 1.5–4]). The outcome had an AUC of 0.85 (95%CI: 0.7–0.98), with a sensitivity of 87%, specificity of 64%, and negative predictive value of 96.4% for a score <3.5 points. Children who scored ≥3.5 points were more likely to require respiratory support within the next 24 h (estimated event-free survival of 82.9% compared to 100%, log-rank test p-value = 0.02). The results suggest that integrating lung ultrasound findings into clinical scores when evaluating infants with acute bronchiolitis could be a promising tool for improving prognosis.

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“…Rough estimates of the relative position of intrapulmonary lesions can also be obtained. LUS can detect small multifocal consolidations adherent to the subpleural surface [15,16]. Its main disadvantages include the reliance on operator skills for accurate results, the potential for time-intensive procedures (taking up to 20 min per examination), and the presence of hidden areas, like the subscapular or central lung regions, where a comprehensive assessment of parenchyma may not be achievable.…”

Section: Lung Ultrasoundmentioning

confidence: 99%

Imaging of Acute Complications of Community-Acquired Pneumonia in the Paediatric Population—From Chest Radiography to MRI

Alexopoulou,

Prountzos,

Raissaki

et al. 2024

Children

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The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not respond to treatment, need hospitalisation, or have hospital-acquired pneumonia. This review discusses the imaging findings for acute CAP complications and the diagnostic role of each imaging modality. Pleural effusion, empyema, necrotizing pneumonia, abscess, pneumatocele, pleural fistulas, and paediatric acute respiratory distress syndrome (PARDS) are acute CAP complications. When evaluating complicated CAP patients, chest radiography, lung ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) can be used, with each having their own pros and cons. Imaging is usually not needed for CAP diagnosis, but it is essential for complicated cases and follow-ups. Lung ultrasound can supplement chest radiography (CR), which starts the diagnostic algorithm. Contrast-enhanced computed tomography (CECT) is used for complex cases. Advances in MRI protocols make it a viable alternative for diagnosing CAP and its complications.

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Lung ultrasound systematic review shows its prognostic and diagnostic role in acute viral bronchiolitis

Cited by 6 publications

References 51 publications

Are lung ultrasound features more severe in infants with bronchiolitis and coinfections?

Are lung ultrasound features more severe in infants with bronchiolitis and coinfections?

Lung Ultrasound: A Useful Prognostic Tool in the Management of Bronchiolitis in the Emergency Department

Imaging of Acute Complications of Community-Acquired Pneumonia in the Paediatric Population—From Chest Radiography to MRI

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