Prognostic Value of the Area of Lung Involved in Severe and Non-Severe Bronchiolitis: An Observational, Ultrasound-Based Study.

Autor: Camporesi A; Pediatric Anesthesia and Intensive Care, Buzzi Children's Hospital, 20154 Milano, Italy., Vetrugno L; Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy., Morello R; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario 'A. Gemelli', 00168 Roma, Italy., De Rose C; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario 'A. Gemelli', 00168 Roma, Italy., Ferrario S; Pediatric Anesthesia and Intensive Care, Buzzi Children's Hospital, 20154 Milano, Italy., Buonsenso D; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario 'A. Gemelli', 00168 Roma, Italy.; Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Dec 23; Vol. 13 (1). Date of Electronic Publication: 2023 Dec 23.
DOI: 10.3390/jcm13010084
Abstrakt: Background: Point of care lung ultrasound (LUS) has a definite role in viral bronchiolitis when combined with clinical data. Previous data showed a bigger involvement of the superior lung zones in more severe cases. The aim of the present study is to describe whether different lung areas are implicated to different degrees in patients admitted to a Pediatric Intensive Care Unit (PICU) and needing ventilation compared to those with less severe forms.
Methods: observational, prospective study. LUS scores of single lung areas and clinical data were collected for all children aged 0-12 months presenting with bronchiolitis to the participating centers and used as covariates for logistic regression having "PICU admission" as outcome. A subsequent analysis was carried out to investigate factors concurring with different lung zones' involvement.
Results: 173 patients were enrolled. Difficulty in feeding, presence of wheezing, SpO 2 were all risk factors for PICU admission. Superior lung areas' LUS scores presented higher Odds Ratios for PICU admission and need for ventilation than inferior ones. Age and prematurity concurred in determining their higher LUS scores.
Conclusions: Superior lobes' greater involvement could be favored by the geometrical distribution of relative bronchi, exiting with an acute angle from mainstem bronchi in small children where airway caliber is small and only small volumes of secretions can be occlusive.
Databáze: MEDLINE
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