Application of POCUS lung ultrasound in infants with bronchiolitis: a prospective study

Abstract

BACKGROUND: Acute bronchiolitis is a viral infection of the lower respiratory tract typical of the pediatric age and of the winter season. It represents the leading cause of hospitalization in the first year of life in industrialized countries. Several authoritative scientific societies have issued guidelines for the diagnostic and therapeutic management of bronchiolitis, and they limit the use of radiological imaging in the diagnosis of the pathology, which is mostly clinical.METHODS: For this reason, in the light of the amount of work published in the literature on the application of lung ultrasound in the diagnosis and follow-up of pneumonia, the idea of its use in the integrated evaluation of patients with clinical suspicion has gained ground of bronchiolitis and especially POCUS. This study has the following objectives: 1) verify the existence of a clinical-ultrasound correlation; 2) ability of the clinical score and the ultrasound score to predict the need for ventilatory support; 3) compare point-of-care lung ultrasound and chest X-ray.RESULTS: This work adds to the numerous studies already published which have investigated the potential of lung ultrasound performed by clinicians in cases of bronchiolitis, beyond now validated contexts, such as the evaluation of pleural effusions and pneumothorax.CONCLUSIONS: The advantages of LUS are considerable: safe, rapid, accurate, simple, executable and repeatable technique at the patient’s bed, free from exposure to ionizing radiation and, therefore, it would be desirable to spread it more widely in the pediatric field.