Ten Years of Pediatric Lung Ultrasound: A Narrative Review

Abstract

Lung diseases are the most common conditions in newborns, infants, and children and are also the primary cause of death in children younger than 5 years old. Traditionally, the lung was not thought to be a target for an ultrasound due to its inability to penetrate the gas-filled anatomical structures. With the deepening of knowledge on ultrasound in recent years, it is now known that the affected lung produces ultrasound artifacts resulting from the abnormal tissue/gas/tissue interface when ultrasound sound waves penetrate lung tissue. Over the years, the application of lung ultrasound (LUS) has changed and its main indications in the pediatric population have expanded. This review analyzed the studies on lung ultrasound in pediatrics, published from 2010 to 2020, with the aim of highlighting the usefulness of LUS in pediatrics. It also described the normal and abnormal appearances of the pediatric lung on ultrasound as well as the benefits, limitations, and possible future challenges of this modality.

Lung Ultrasound in Adults and Children with COVID-19: From First Discoveries to Recent Advances

“…Pediatricians started implementing LUS approximately ten years before the beginning of the pandemic [ 26 ], with some centers already using it as a standardized clinical tool and with a formal report form [ 27 ]. Therefore, it was not unexpected that LUS was evaluated in pediatric COVID-19.…”

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

“…Point of care lung ultrasonography can facilitate early diagnosis of pulmonary pathology and, therefore, improved outcomes 39 in critically ill children. Children are great candidates for lung US due to their thinner chest wall and smaller thoracic width.…”

“…However, the comparison of lung US to lung CT would be unethical due to the risk of radiation exposure. 39 …”

Now lung ultrasound has been established as a fundamental examination in pediatric respiratory diseases

“…Finally, the usefulness of lung ultrasound may be limited in children with chronic lung diseases with pathophysiological features, such as air trapping and hypoalveolarization. 10,11) The usefulness of lung ultrasound in pediatric respiratory diseases was established in several studies over the past 10 years. Knowledge of lung ultrasound is increasing, and it now represents a fundamental examination modality for pediatric respiratory diseases.…”

“…In addition, its use is difficult in a patient’s paravertebral area or in patients with obesity, subcutaneous emphysema, or wounds. Finally, the usefulness of lung ultrasound may be limited in children with chronic lung diseases with pathophysiological features, such as air trapping and hypoalveolarization [ 10 , 11 ].…”