Utilidad de la ecografía pulmonar precoz en bronquiolitis aguda leve-moderada: estudio piloto

Garrote, Elia Zoido; Aparicio, Cristina; Villarroel, Constanza Camila Torrez; García, Antonio Pedro Vega; Fontan, M; Oulego-Erróz, Ignacio

doi:10.1016/j.anpedi.2018.03.002

Cited by 12 publications

(6 citation statements)

References 23 publications

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“…An observational prospective study by Zoido Garrote et al demonstrated a moderate correlation between LUS findings at hospital admission and the severity of the clinical course, confirming also the higher involvement of the posterior paravertebral and subscapular areas as main severity indexes [ 17 ].…”

Section: Discussionmentioning

confidence: 93%

Lung Ultrasound and Clinical Progression of Acute Bronchiolitis: A Prospective Observational Single-Center Study

et al. 2020

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Background and Objectives: Recent literature suggests that lung ultrasound might have a role in the diagnosis and management of bronchiolitis. The aim of the study is to evaluate the relationship between an ultrasound score and the clinical progression of bronchiolitis: need for supplemental oxygen, duration of oxygen therapy and hospital stay. Materials and Methods: This was a prospective observational single-center study, conducted in a pediatric unit during the 2017–2018 epidemic periods. All consecutive patients admitted with clinical signs of acute bronchiolitis, but without the need for supplemental oxygen, underwent a lung ultrasound in the first 24 h of hospital care. The lung involvement was graded based on the ultrasound score. During clinical progression, need for supplemental oxygen, duration of oxygen therapy and duration of hospital stay were recorded. Results: The final analysis included 83 patients, with a mean age of 4.5 ± 4.1 months. The lung ultrasound score in patients that required supplemental oxygen during hospitalization was 4.5 ± 1.7 (range: 2.0–8.0), different from the one of the not supplemented infants (2.5 ± 1.8; range: 0.0–6.0; p < 0.001). Ultrasound score was associated with the need for supplemental oxygen (OR = 2.2; 95% CI = 1.5–3.3; p < 0.0001). Duration of oxygen therapy was not associated with LUS score (p > 0.05). Length of hospital stay (coef. = 0.5; 95% CI = 0.2–0.7; p < 0.0001) correlates with LUS score. Conclusion: Lung ultrasound score correlates with the need of supplemental oxygen and length of hospital stay in infants with acute bronchiolitis.

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Section: Discussionmentioning

confidence: 93%

Lung Ultrasound and Clinical Progression of Acute Bronchiolitis: A Prospective Observational Single-Center Study

et al. 2020

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“…Although an association between LUS and bronchiolitis severity was already partially seen in previous studies [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ], they were monocentric and included relatively small samples. More importantly, they included a combination of artifacts, not in line with recent advances in the field of LUS which highlight the potential of the multiple possible artifacts to be used to provide a semi-quantitative assessment of lung disease [ 32 , 33 , 35 , 36 , 38 ].…”

Section: Discussionmentioning

confidence: 98%

“…Exclusion criteria (based on clinical-anamnestic data, not on ultrasound findings), in analogy to the literature [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ] were applied rigorously to avoid over fitting: children with immunosuppression, heart diseases, pneumonia (when the clinician according to clinical, laboratory and radiologic data classified the child has having pneumonia rather than bronchiolitis), neuromuscular diseases, cystic fibrosis, bronchopulmonary dysplasia (excluded according to the perinatal history, dependence of oxygen), positive history of foreign body inhalation, unstable critical conditions that required immediate life-saving procedures, and lack of parental consent. No control cases were enrolled because the aim of the study was to compare different stages of clinically diagnosed bronchiolitis.…”

Section: Methodsmentioning

confidence: 99%

“…Current guidelines do not suggest to routinely perform laboratory tests and, importantly, chest X-rays should be reserved for the most severe cases [ 2 ]. During the last decade, lung ultrasound (LUS) has been proved to be a useful diagnostic tool in many pediatric and neonatal diseases [ 8 , 9 , 10 , 11 , 12 ] and its application and utility in the management of bronchiolitis has also been reported [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Role of Lung Ultrasound in Children with Bronchiolitis: Multicentric Prospective Study

Gori¹,

Amendolea²,

Buonsenso

et al. 2022

JCM

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There is increasing recognition of the role of lung ultrasound (LUS) to assess bronchiolitis severity in children. However, available studies are limited to small, single-center cohorts. We aimed to assess a qualitative and quantitative LUS protocol to evaluate the course of bronchiolitis at diagnosis and during follow-up. This is a prospective, multicenter study. Children with bronchiolitis were stratified according to clinical severity and underwent four LUS evaluations at set intervals. LUS was classified according to four models: (1) positive/negative; (2) main LUS pattern (normal/interstitial/consolidative/mixed) (3) LUS score; (4) LUS score with cutoff. Two hundred and thirty-three children were enrolled. The baseline LUS was significantly associated with bronchiolitis severity, using both the qualitative (positive/negative LUS p < 0.001; consolidated/normal LUS pattern or mixed/normal LUS p < 0.001) and quantitative models (cutoff score > 9 p < 0.001; LUS mean score p < 0.001). During follow-up, all LUS results according to all LUS models improved (p < 0.001). Better cut off value was declared at a value of >9 points. Conclusions: Our study supports the role of a comprehensive qualitative and quantitative LUS protocol for the identification of severe cases of bronchiolitis and provides data on the evolution of lung aeration during follow-up.

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“…This report is based on deep literature research over the last 20 years with the aim of providing clinical indi- Starting from the knowledge of most common sonographic findings, ultrasound severity scores can be developed to correctly stratify affected children and to predict the clinical course of bronchiolitis; they can also be compared with clinical scores based on the most common symptoms and signs with a reported agreement of 90.6%. LUS allows for the identification of patients in need of supplemental oxygen with high sensitivity and specificity (96.6% and 98.7%, respectively) and correlates with the length of hospital stay [104][105][106][107][108]. According to Bueno-Campana, the identification of at least one consolidation >1 cm in the posterior areas has a relative risk of 4.4 for the need of non-invasive ventilation [109].…”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound in Pediatrics and Neonatology: An Update

Ammirabile

Buonsenso

Mauro³

2021

Healthcare

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The potential role of ultrasound for the diagnosis of pulmonary diseases is a recent field of research, because, traditionally, lungs have been considered unsuitable for ultrasonography for the high presence of air and thoracic cage that prevent a clear evaluation of the organ. The peculiar anatomy of the pediatric chest favors the use of lung ultrasound (LUS) for the diagnosis of respiratory conditions through the interpretation of artefacts generated at the pleural surface, correlating them to disease-specific patterns. Recent studies demonstrate that LUS can be a valid alternative to chest X-rays for the diagnosis of pulmonary diseases, especially in children to avoid excessive exposure to ionizing radiations. This review focuses on the description of normal and abnormal findings during LUS of the most common pediatric pathologies. Current literature demonstrates usefulness of LUS that may become a fundamental tool for the whole spectrum of lung pathologies to guide both diagnostic and therapeutic decisions.

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Utilidad de la ecografía pulmonar precoz en bronquiolitis aguda leve-moderada: estudio piloto

Abstract: There is a moderate correlation between early lung ultrasound findings with the severity of the AB evaluated by the clinical scales, as well as some relationship with the clinical progression.

Cited by 12 publications

References 23 publications

Lung Ultrasound and Clinical Progression of Acute Bronchiolitis: A Prospective Observational Single-Center Study

Lung Ultrasound and Clinical Progression of Acute Bronchiolitis: A Prospective Observational Single-Center Study

Prognostic Role of Lung Ultrasound in Children with Bronchiolitis: Multicentric Prospective Study

Lung Ultrasound in Pediatrics and Neonatology: An Update

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