In:
Pediatric Pulmonology, Wiley, Vol. 55, No. 10 ( 2020-10), p. 2799-2805
Abstract:
Lung ultrasound (LUS) is an emerging tool that may be used in the diagnosis and follow‐up of children with viral bronchiolitis. In this study, we describe LUS abnormalities in children receiving invasive mechanical ventilation (IMV) for severe bronchiolitis in the pediatric intensive care unit (PICU). Our aim was to semiquantify the loss of aeration and examine the association between serial LUS scores and oxygenation anomaly, as a marker of disease severity. Design Prospective, observational study in a single‐center PICU. Methods LUS was performed by multiple observers using two different LUS scoring systems (counting B‐lines and aeration score) in 17 patients in the PICU, generating 320 images. Oxygen saturation index (OSI) was the primary outcome marker to describe the severity of oxygenation anomaly. Results Pulmonary aeration was moderately impaired with a homogeneous anterolateral pattern. LUS scores worsened after 24 hours, to improve in subsequent days. Both LUS scores were positively correlated with OSI on the first day of IMV (counting B‐lines P = .034, r = .52 and LUS aeration score P = .017, r = .57), but not thereafter. There was considerable variability in the LUS scores despite moderate to high agreement between the observers. Conclusions In children receiving IMV for severe bronchiolitis, pulmonary aeration is moderately impaired. LUS scores positively correlate with severity of oxygenation anomaly only in the acute phase of disease. We speculate that with the progression of disease other factors affect LUS patterns (eg, fluid overload, atelectasis), which may complicate the interpretation of LUS in follow‐up of this specific cohort in the PICU.
Type of Medium:
Online Resource
ISSN:
8755-6863
,
1099-0496
Language:
English
Publisher:
Wiley
Publication Date:
2020
detail.hit.zdb_id:
1491904-7
Permalink
