Cargando…

Use of lung ultrasound in school-aged children with wheezing

BACKGROUND: There 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 Ult...

Descripción completa

Detalles Bibliográficos
Autores principales: Attanasi, Marina, Sferrazza Papa, Simone, Porreca, Annamaria, Sferrazza Papa, Giuseppe F., Di Filippo, Paola, Piloni, Francesca, Dodi, Giulia, Sansone, Francesco, Di Pillo, Sabrina, Chiarelli, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869023/
https://www.ncbi.nlm.nih.gov/pubmed/36699291
http://dx.doi.org/10.3389/fped.2022.926252
_version_ 1784876676257153024
author Attanasi, Marina
Sferrazza Papa, Simone
Porreca, Annamaria
Sferrazza Papa, Giuseppe F.
Di Filippo, Paola
Piloni, Francesca
Dodi, Giulia
Sansone, Francesco
Di Pillo, Sabrina
Chiarelli, Francesco
author_facet Attanasi, Marina
Sferrazza Papa, Simone
Porreca, Annamaria
Sferrazza Papa, Giuseppe F.
Di Filippo, Paola
Piloni, Francesca
Dodi, Giulia
Sansone, Francesco
Di Pillo, Sabrina
Chiarelli, Francesco
author_sort Attanasi, Marina
collection PubMed
description BACKGROUND: There 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 METHODS: We 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. RESULTS: The 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). CONCLUSIONS: Our 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.
format Online
Article
Text
id pubmed-9869023
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-98690232023-01-24 Use of lung ultrasound in school-aged children with wheezing Attanasi, Marina Sferrazza Papa, Simone Porreca, Annamaria Sferrazza Papa, Giuseppe F. Di Filippo, Paola Piloni, Francesca Dodi, Giulia Sansone, Francesco Di Pillo, Sabrina Chiarelli, Francesco Front Pediatr Pediatrics BACKGROUND: There 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 METHODS: We 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. RESULTS: The 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). CONCLUSIONS: Our 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. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9869023/ /pubmed/36699291 http://dx.doi.org/10.3389/fped.2022.926252 Text en © 2023 Attanasi, Sferrazza Papa, Porreca, Sferrazza Papa, Di Filippo, Piloni, Dodi, Sansone, Di Pillo and Chiarelli. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Attanasi, Marina
Sferrazza Papa, Simone
Porreca, Annamaria
Sferrazza Papa, Giuseppe F.
Di Filippo, Paola
Piloni, Francesca
Dodi, Giulia
Sansone, Francesco
Di Pillo, Sabrina
Chiarelli, Francesco
Use of lung ultrasound in school-aged children with wheezing
title Use of lung ultrasound in school-aged children with wheezing
title_full Use of lung ultrasound in school-aged children with wheezing
title_fullStr Use of lung ultrasound in school-aged children with wheezing
title_full_unstemmed Use of lung ultrasound in school-aged children with wheezing
title_short Use of lung ultrasound in school-aged children with wheezing
title_sort use of lung ultrasound in school-aged children with wheezing
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869023/
https://www.ncbi.nlm.nih.gov/pubmed/36699291
http://dx.doi.org/10.3389/fped.2022.926252
work_keys_str_mv AT attanasimarina useoflungultrasoundinschoolagedchildrenwithwheezing
AT sferrazzapapasimone useoflungultrasoundinschoolagedchildrenwithwheezing
AT porrecaannamaria useoflungultrasoundinschoolagedchildrenwithwheezing
AT sferrazzapapagiuseppef useoflungultrasoundinschoolagedchildrenwithwheezing
AT difilippopaola useoflungultrasoundinschoolagedchildrenwithwheezing
AT pilonifrancesca useoflungultrasoundinschoolagedchildrenwithwheezing
AT dodigiulia useoflungultrasoundinschoolagedchildrenwithwheezing
AT sansonefrancesco useoflungultrasoundinschoolagedchildrenwithwheezing
AT dipillosabrina useoflungultrasoundinschoolagedchildrenwithwheezing
AT chiarellifrancesco useoflungultrasoundinschoolagedchildrenwithwheezing