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

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 diagnos...

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Published in:Journal of clinical medicine 2022-07, Vol.11 (14), p.4233
Main Authors: Gori, Laura, Amendolea, Antonella, Buonsenso, Danilo, Salvadori, Stefano, Supino, Maria Chiara, Musolino, Anna Maria, Adamoli, Paolo, Coco, Alfina Domenica, Trobia, Gian Luca, Biagi, Carlotta, Lucherini, Marco, Leonardi, Alberto, Limoli, Giuseppe, Giampietri, Matteo, Sciacca, Tiziana Virginia, Morello, Rosa, Tursi, Francesco, Soldati, Gino, Ecobron Group
Format: Article
Language:English
Subjects:
Acoustics
Clinical medicine
Hypotheses
Laboratories
Longitudinal studies
Neuromuscular diseases
Pediatrics
Pneumonia
Quantitative analysis
Ultrasonic imaging
Variables
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Summary: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.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11144233