Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population

Riccardo Inchingolo, Roberto Copetti, Andrea Smargiassi, Rafael Emanuele Gerardi, Emanuele Giovanni Conte, Giuseppe Maria Corbo, Antonio Gatto, Chiara Pierandrei, Lavinia Capossela, Ilaria Lazzareschi, Piero Valentini, Libertario Demi, Riccardo Inchingolo, Roberto Copetti, Andrea Smargiassi, Rafael Emanuele Gerardi, Emanuele Giovanni Conte, Giuseppe Maria Corbo, Antonio Gatto, Chiara Pierandrei, Lavinia Capossela, Ilaria Lazzareschi, Piero Valentini, Libertario Demi

Abstract

Aims: Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization.

Methods: Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted.

Results: Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008).

Conclusions: USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP.

Trial registration number and date of registration: NCT03556488, June 14, 2018.

Keywords: Air bronchogram; Children; Imaging; Pneumonia; Score; Ultrasound.

Conflict of interest statement

The authors have no conflicts of interest relevant to this article to disclose.

Figures

Fig. 1
Fig. 1
Cyclical evolution of US lung patterns of pneumonia evaluated by USINCHILD score
Fig. 2
Fig. 2
Cox regression analysis of lenght of hospitalization and defervescence time

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