Pediatric Point-of-Care Lung Ultrasonography: A Narrative Review

Rizvi, Munaza; Rabiner, Joni E.

doi:10.5811/westjem.2022.3.54663

Cited by 7 publications

(5 citation statements)

References 40 publications

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“…Similar results were also highlighted for family pediatricians. A possible explanation for this finding may be the steep learning curve which also allows novices to be able to perform lung US [ 25 ]. It should be also underlined that nearly one third of respondents assessed to use US for cardiac and abdominal application: traditionally, the use of US for these two anatomic regions is a prerogative of cardiologists and radiologists, respectively [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Pediatric ultrasound practice in Italy: an exploratory survey

Musolino,

Tei,

De Rose

et al. 2024

Ital J Pediatr

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Background The aim of this exploratory survey is to describe the current state of US (ultrasound) technique across different pediatric settings nationwide. Methods A questionnaire was emailed to all members of the Italian Society of Pediatrics, including pediatric residents. The survey was open from December 2021 to March 2022. Results There were 1098 respondents. Seven hundred and seven pediatricians (84.1%) reported any use of US, while 51 (44.3%) residents denied it. The majority of participants (n = 956, 87.1%) reported to have a US machine available within the department, mostly cart-based (n = 516, 66.9%) and provided from 1 to 5 years prior to the survey (n = 330, 42.8%). Lung and neonatal cerebral regions were the most frequently scanned (n = 289, 18.7% and n = 218, 14.1%, respectively). The suspicion of pneumonia or respiratory distress represented the main reasons for performing US in emergency room (n = 390, 78% and n = 330, 66%, respectively). The majority of family pediatricians reported to scan lung and kidney/urinary tract regions (n = 30, 16.9%, and n = 23,12.9%, respectively). Regarding US training, the majority of respondents (n = 358, 34.6%) declared an experience-based education, with a deficient certification enabling the use of US in 71.6% (n = 552) of cases. The most common barriers included the lack of a well-defined training program (n = 627, 57.1%), unavailability of the US machine (n = 196, 17.9%) and legal responsibility concern (n = 175, 15.9%). Conclusions Despite the growing interest on pediatric US nationally, significant barriers still limit widespread adoption. These obstacles may be addressed through the dissemination of a specific US education plan and providing additional resources.

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Section: Discussionmentioning

confidence: 99%

Pediatric ultrasound practice in Italy: an exploratory survey

Musolino,

Tei,

De Rose

et al. 2024

Ital J Pediatr

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“…LUS can improve early diagnosis of lung diseases in critically ill children, being more sensitive than CXR and comparable to CT, without radiation exposure. Although it is operator dependent, different studies have shown that even beginners can perform it with high precision, showing adequate interobserver agreement in image interpretation [63,64]. Obesity and subcutaneous emphysema are the primary patient-related factors that can limit the effectiveness of LUS.…”

Section: Discussionmentioning

confidence: 99%

“…There is a limitation to using LUS for the location of pulmonary pathology since it cannot visualize the etiologies that do not extend to the pleural surface. However, more than 95% of pulmonary pathological processes have a pleural component in both adults and pediatric patients, making ultrasound useful in most cases [63,65].…”

Section: Discussionmentioning

confidence: 99%

The Clinical Pulmonary Infection Score Combined with Procalcitonin and Lung Ultrasound (CPIS-PLUS), a Good Tool for Ventilator Associated Pneumonia Early Diagnosis in Pediatrics

Becerra-Hervás,

Guitart,

Covas

et al. 2024

Children

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Ventilator-associated pneumonia (VAP) is common in Pediatric Intensive Care Units. Although early detection is crucial, current diagnostic methods are not definitive. This study aimed to identify lung ultrasound (LUS) findings and procalcitonin (PCT) values in pediatric patients with VAP to create a new early diagnosis score combined with the Clinical Pulmonary Infection Score (CPIS), the CPIS-PLUS score. Prospective longitudinal and interventional study. Pediatric patients with suspected VAP were included and classified into VAP or non-VAP groups, based on Centers of Disease Control (CDC) criteria for the final diagnosis. A chest-X-ray (CXR), LUS, and blood test were performed within the first 12 h of admission. CPIS score was calculated. A total of 108 patients with VAP suspicion were included, and VAP was finally diagnosed in 51 (47%) patients. CPIS-PLUS showed high accuracy in VAP diagnosis with a sensitivity (Sn) of 80% (95% CI 65–89%) and specificity (Sp) of 73% (95% CI 54–86%). The area under the curve (AUC) resulted in 0.86 for CPIS-PLUS vs. 0.61 for CPIS. In conclusion, this pilot study showed that CPIS-PLUS could be a potential and reliable tool for VAP early diagnosis in pediatric patients. Internal and external validations are needed to confirm the potential value of this score to facilitate VAP diagnosis in pediatric patients.

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“…As reflections occur at bone and air interfaces, diagnosis around those structures is often hindered. In addition, only a small part of the body can be examined simultaneously, and, most importantly, there is a strong dependence on the examiner and very few possibilities for post-hoc assessment of US images [ 6 ].…”

Section: Faster Than the Child’s Movement And The Movement Of The Hea...mentioning

confidence: 99%

Real-time MRI: a new tool of radiologic imaging in small children

et al. 2023

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Real-time MRI (rt-MRI) in children is a new imaging technique that combines the advantages of US — at frame rates of up to 50 images per second — with the quality and features of MRI. Although still subject of research, it has become a standard tool in the diagnostic portfolio of two pediatric radiology departments in Germany. Based on ultrashort acquisition times, any detrimental effects of macroscopic movements of the child and the physiological movements of the organs are negligible. Especially in pediatric brain imaging, rt-MRI has already proven its value. With suitable indications, rt-MRI can reduce anesthesia and sedation examinations in children below 6 years of age by 40% due to its very short examination time and its robustness to motion. There is a high level of acceptance among parents and referrers when diagnostic possibilities and limitations are communicated correctly. Conclusion: Completely new diagnostic possibilities arise in the imaging of the moving lung, the beating heart, joint movements, and speaking and swallowing, as demonstrated in this video-backed review. What is known:• MRI in moving children has been burdened with severe artifacts.• Gross motion usually has to be handled by sedation and periodic motion of the heart and lungs has to be compensated with time-consuming techniques until now. What is new:• Real-time MRI allows image acquisition with up to 50 frames per second similar to ultrasound frame rate.• Real-time MRI proofs to be very promising for imaging children, reducing examination time and sedation rate drastically.

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Pediatric Point-of-Care Lung Ultrasonography: A Narrative Review

Cited by 7 publications

References 40 publications

Pediatric ultrasound practice in Italy: an exploratory survey

Pediatric ultrasound practice in Italy: an exploratory survey

The Clinical Pulmonary Infection Score Combined with Procalcitonin and Lung Ultrasound (CPIS-PLUS), a Good Tool for Ventilator Associated Pneumonia Early Diagnosis in Pediatrics

Real-time MRI: a new tool of radiologic imaging in small children

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