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Point-of-care lung ultrasound in children with bronchiolitis in a pediatric emergency department.
Arch Pediatr. 2021 Jan; 28(1):64-68.AP

Abstract

OBJECTIVES

This study assessed the association between findings of lung ultrasound (LUS) performed in the pediatric emergency department (PED) on infants with bronchiolitis and need for respiratory support.

METHODS

An observational study was carried out in the PED during the epidemic seasons in two consecutive years. Infants diagnosed with bronchiolitis who fulfilled the inclusion criteria were evaluated. A group of six pediatricians performed LUS and classified lung findings into four groups: normal pattern (A), moderate interstitial pattern (B1), severe interstitial pattern (B2), and isolated consolidation (C). The relationship between LUS findings and need for respiratory support was explored. An expert sonographer, blinded to the results, reviewed the ultrasound studies to determine the interobserver reliability.

RESULTS

A total of 200 infants were included (mean age 5.7 months±4.4 SD); 65 (32.5%) obtained moderate clinical scores, while 23 (11.5%) needed respiratory support at admission and 34 (17.0%) at 48h. The ultrasound findings in the PED were the following: A=89 (44.5%), B1=55 (27.5%), B2=34 (17%), and C=22 (11%). Age less than 6 weeks and moderate bronchiolitis were correlated with abnormal LUS (P<0.005). The severity of interstitial ultrasound pattern has some correlation with an increased need for respiratory support. The interobserver concordance was high (0.95, confidence interval: 0.92-0.98).

CONCLUSION

LUS is a feasible tool that may help to confirm the clinical impression and assess the need for respiratory support in children with bronchiolitis, but further multicenter studies are needed.

Authors+Show Affiliations

Division of Pediatric Emergency Medicine, Basurto University Hospital, Montevideo Avenue, 18, 48013 Bilbao, Spain.Division of Pediatric Emergency Medicine, Basurto University Hospital, Montevideo Avenue, 18, 48013 Bilbao, Spain.Research Unit REDISSEC, Basurto University Hospital, Bilbao, Spain.Division of Pediatric Emergency Medicine, Basurto University Hospital, Montevideo Avenue, 18, 48013 Bilbao, Spain.Division of Pediatric Emergency Medicine, Basurto University Hospital, Montevideo Avenue, 18, 48013 Bilbao, Spain.Division of Pediatric Emergency Medicine, Basurto University Hospital, Montevideo Avenue, 18, 48013 Bilbao, Spain. Electronic address: frederic.samson@osakidetza.eus.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33162325

Citation

San Sebastian Ruiz, N, et al. "Point-of-care Lung Ultrasound in Children With Bronchiolitis in a Pediatric Emergency Department." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 28, no. 1, 2021, pp. 64-68.
San Sebastian Ruiz N, Rodríguez Albarrán I, Gorostiza I, et al. Point-of-care lung ultrasound in children with bronchiolitis in a pediatric emergency department. Arch Pediatr. 2021;28(1):64-68.
San Sebastian Ruiz, N., Rodríguez Albarrán, I., Gorostiza, I., Galletebeitia Laka, I., Delgado Lejonagoitia, C., & Samson, F. (2021). Point-of-care lung ultrasound in children with bronchiolitis in a pediatric emergency department. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 28(1), 64-68. https://doi.org/10.1016/j.arcped.2020.10.003
San Sebastian Ruiz N, et al. Point-of-care Lung Ultrasound in Children With Bronchiolitis in a Pediatric Emergency Department. Arch Pediatr. 2021;28(1):64-68. PubMed PMID: 33162325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Point-of-care lung ultrasound in children with bronchiolitis in a pediatric emergency department. AU - San Sebastian Ruiz,N, AU - Rodríguez Albarrán,I, AU - Gorostiza,I, AU - Galletebeitia Laka,I, AU - Delgado Lejonagoitia,C, AU - Samson,F, Y1 - 2020/11/06/ PY - 2019/09/25/received PY - 2020/06/15/revised PY - 2020/10/02/accepted PY - 2020/11/10/pubmed PY - 2020/11/10/medline PY - 2020/11/9/entrez KW - Bronchiolitis KW - Lung ultrasound KW - POCUS KW - Pediatric emergency department SP - 64 EP - 68 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 28 IS - 1 N2 - OBJECTIVES: This study assessed the association between findings of lung ultrasound (LUS) performed in the pediatric emergency department (PED) on infants with bronchiolitis and need for respiratory support. METHODS: An observational study was carried out in the PED during the epidemic seasons in two consecutive years. Infants diagnosed with bronchiolitis who fulfilled the inclusion criteria were evaluated. A group of six pediatricians performed LUS and classified lung findings into four groups: normal pattern (A), moderate interstitial pattern (B1), severe interstitial pattern (B2), and isolated consolidation (C). The relationship between LUS findings and need for respiratory support was explored. An expert sonographer, blinded to the results, reviewed the ultrasound studies to determine the interobserver reliability. RESULTS: A total of 200 infants were included (mean age 5.7 months±4.4 SD); 65 (32.5%) obtained moderate clinical scores, while 23 (11.5%) needed respiratory support at admission and 34 (17.0%) at 48h. The ultrasound findings in the PED were the following: A=89 (44.5%), B1=55 (27.5%), B2=34 (17%), and C=22 (11%). Age less than 6 weeks and moderate bronchiolitis were correlated with abnormal LUS (P<0.005). The severity of interstitial ultrasound pattern has some correlation with an increased need for respiratory support. The interobserver concordance was high (0.95, confidence interval: 0.92-0.98). CONCLUSION: LUS is a feasible tool that may help to confirm the clinical impression and assess the need for respiratory support in children with bronchiolitis, but further multicenter studies are needed. SN - 1769-664X UR - https://www.unboundmedicine.com/medline/citation/33162325/Point_of_care_lung_ultrasound_in_children_with_bronchiolitis_in_a_pediatric_emergency_department_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(20)30223-2 DB - PRIME DP - Unbound Medicine ER -
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