Consensus on the Application of Lung Ultrasound in Pneumonia and Bronchiolitis in Children

Abstract

This evidence-based consensus aims to establish the role of point-of-care lung ultrasound in the management of pneumonia and bronchiolitis in paediatric patients. A panel of thirteen experts form five Polish tertiary pediatric centres was involved in the development of this document. The literature search was done in PubMed database. Statements were established based on a review of full-text articles published in English up to December 2019. The development of this consensus was conducted according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations)—adopted and Delphi method. Initially, 22 proposed statements were debated over 3 rounds of on-line discussion and anonymous voting sessions. A total of 17 statements were agreed upon, including four statements referring to general issues, nine referring to pneumonia and four to bronchiolitis. For five statements experts did not achieve an agreement. The evidence supporting each statement was evaluated to assess the strength of each statement. Overall, eight statements were rated strong, five statements moderate, and four statements weak. For each statement, experts provided their comments based on the literature review and their own experience. This consensus is the first to establish the role of lung ultrasound in the diagnosis and management of pneumonia and bronchiolitis in children as an evidence-based method of imaging.

Lung Ultrasound: Its Findings and New Applications in Neonatology and Pediatric Diseases

“…As recently observed [ 12 ], the timing of performance of lung ultrasound is a pivotal element to be evaluated in order to use the full potential of the method. At the moment, there are no studies that directly analyze the impact of the timing of execution in some clinical conditions on its accuracy, but it seems reasonable that ultrasound should be performed as soon as possible or at least within 24 h of admission to the hospital in the case of infectious diseases [ 13 ].…”

Serial lung ultrasounds in pediatric pneumonia in Mozambique and Pakistan

“…Given the frequent lack of imaging capacity in resource-constrained settings and restrictions on use of imaging modalities with ionizing radiation in pediatric populations, much remains unknown about what takes place in the lungs of children with chest-indrawing pneumonia undergoing antibiotic treatment in resource-constrained settings. Lung ultrasound (LUS) is a portable, point-of-care tool that can dynamically visualize lungs at the bedside with promising diagnostic accuracy for pneumonia and greater sensitivity or specificity when compared with chest radiography (CXR) 2 – 5 . LUS can be used to visualize the lungs multiple times over the course of a child’s illness without risk of exposing the child to ionizing radiation.…”

Comment on Jaworska, J. et al. Consensus on the Application of Lung Ultrasound in Pneumonia and Bronchiolitis in Children. Diagnostics 2020, 10, 935

“…We have read with great interest the article by Jaworska et al [ 1 ] concerning the role of Lung Ultrasound (LUS) in pneumonia and bronchiolitis in children.…”