Use of lung ultrasound in school-aged children with wheezing

被引:5
|
作者
Attanasi, Marina [1 ]
Papa, Simone Sferrazza [1 ]
Porreca, Annamaria [2 ]
Papa, Giuseppe F. Sferrazza F. [3 ,4 ]
Di Filippo, Paola [1 ]
Piloni, Francesca [1 ]
Dodi, Giulia [1 ]
Sansone, Francesco [1 ]
Di Pillo, Sabrina [1 ]
Chiarelli, Francesco [1 ]
机构
[1] Univ G dAnnunzio, Dept Pediat, Pediat Allergy & Pulmonol Unit, Chieti, Italy
[2] Univ G dAnnunzio, Dept Econ Studies, Chieti, Italy
[3] Univ Milan, Dept Hlth Sci, Milan, Italy
[4] Casa Cura Policlin, Dept Neurorehabil Sci, Milan, Italy
来源
FRONTIERS IN PEDIATRICS | 2023年 / 10卷
关键词
lung ultrasound; children; wheezing; respiratory tract infections; pneumonia; ACUTE-ASTHMA-EXACERBATIONS; EMERGENCY-DEPARTMENT; ALVEOLAR TISSUE; CARE; POINT; DIAGNOSIS; PNEUMONIA; INFECTIONS; SPIROMETRY; SEVERITY;
D O I
10.3389/fped.2022.926252
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundThere is limited information available on fast and safe bedside tools that could help clinicians establish whether the pathological process underlying cases of wheezing is due to asthmatic exacerbation, asthmatic bronchitis, or pneumonia. The study's aim was to characterize Lung Ultrasound (LUS) in school-aged children with wheezing and evaluate its use for their follow-up treatment. Materials and methodsWe carried out a cross-sectional study involving 68 consecutive outpatients (mean age 9.9 years) with wheezing and suggestive signs of an acute respiratory infection. An expert sonographer, blinded to all subject characteristics, clinical course, and the study pediatrician's diagnosis, performed an LUS after spirometry and before BDT. The severity of acute respiratory symptoms was determined using the Pediatric Respiratory Assessment Measure (PRAM) score. ResultsThe LUS was positive in 38.2% (26/68) of patients [12 (46.1%) with multiple B-lines, 24 (92.3%) with consolidation, and 22 (84.6%) with pleural abnormalities]. In patients with pneumonia, asthmatic bronchitis, and asthma, the percentages of those patients with a positive LUS were 100%, 57.7%, and 0%, respectively. Of note, patients with a positive LUS were associated with an increased need for hospital admission (30.8% vs. 2.4%, p = 0.001), administration of oxygen therapy (14.6% vs. 0%, p = 0.009), oral corticosteroids (84.6% vs. 19.0%, p < 0.001), and antibiotics (88.5% vs. 11.9%, p < 0.001); and a higher median value of PRAM score (4.0 (2.0-7.0) vs. 2.0 (1.0-5.0); p < 0.001). ConclusionsOur findings would suggest the use of LUS as a safe and cheap tool used by clinicians to define the diagnosis of school-aged children with wheezing of unknown causes.
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页数:9
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