The Diagnostic Value of Lung Ultrasound in Neonates and Infants with Acute Bronchiolitis

Abstract

Objective − We analysed the relationship between the lung ultrasound (LUS) score and clinical characteristics in order to evaluate the diagnostic and predictive value of LUS in neonates and infants with acute bronchiolitis. Subjects and

Methods − Term infants aged up to 3 months, admitted to Ljubljana University Children’s Hospital due to acute bronchiolitis in the period from January to April 2020, were studied prospectively. LUS score and clinical assessment score (CAS) were determined upon admission. The patients were divided into groups according to LUS score and CAS. Clinical and laboratory characteristics were compared between the groups. Correlations between LUS score, duration of clinical signs prior to admission, CAS and partial carbon dioxide pressure in the capillary blood (PCO2) upon admission, length of hospitalization and duration of supplemental oxygen (O2) therapy were analysed. Additionally, the predictive value of LUS and CAS for the need of non-invasive respiratory support (NRS) was calculated.

Results − The LUS score correlated with the clinical severity of acute bronchiolitis. Patients with higher LUS score had higher CAS (P<0.001) and PCO2 upon admission (P=0.014), and needed O2 therapy for a longer time (P=0.023). These patients also required NRS (P=0.024) more often, were positive for respiratory syncytial virus (P=0.008), and had a chest X-ray performed (P<0.001). The LUS score correlated well with CAS (P<0.001, r=0.762). LUS score at admission underperformed to identify subsequent NRS treatment needs (AUC 0.76 (0.54-0.97), P=0.069) compared to CAS (AUC 0.85 (0.68-1.00), P=0.013).

Conclusions − Larger studies are needed to evaluate the predictive and diagnostic value of LUS in neonates and young infants with acute bronchiolitis.