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Minerva Anestesiologica 2021 June;87(6):675-83

DOI: 10.23736/S0375-9393.21.15155-7


language: English

Modified pediatric lung ultrasound score compared with computed tomography for assessment of lung aeration in children

Oliviero FOCHI 1 , Alfio BRONCO 2, Mirco NACOTI 1, Davide SIGNORI 2, Stefano GATTI 2, Francesco SALA 3, Thomas ROZEN 4, 5, 6, Ezio BONANOMI 1, Giacomo BELLANI 2, 7

1 Department of Pediatric Anesthesia and Intensive Care, ASST Papa Giovanni XXIII, Bergamo, Italy; 2 Department of Emergency and Intensive Care, San Gerardo Hospital, Monza, Monza-Brianza, Italy; 3 Department of Radiology, ASST Papa Giovanni XXIII, Bergamo, Italy; 4 Pediatric Intensive Care Unit, Royal Children’s Hospital, Melbourne, Australia; 5 University of Melbourne, Melbourne, Australia; 6 Murdoch Children’s Research Institute, Melbourne, Australia; 7 Faculty of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

BACKGROUND: Lung ultrasound can be used to assess lung density and aeration at the bedside. Few authors have investigated scores based on the ultrasonographic interstitial syndrome for this purpose, but none have compared them with the gold standard computed tomography in children.
METHODS: Children <10 kilograms undergoing a chest computed tomography for clinical purposes at a tertiary hospital Pediatric Intensive Care Unit were enrolled in the study. An ultrasound scan was performed shortly after computed tomography. Each hemithorax was divided in six zones, and each zone was scored: 1, no B lines; 2, <3 B lines; 3, >3 well separated B lines; 4, crowded, coalescent B lines; 5, white lung; 6, consolidation. The pediatric lung ultrasound score was obtained by adding all zones. Interobserver variation for two separate operators was calculated.
RESULTS: Ten children, median age 95 days (range 23-721) were enrolled. Mean pediatric lung ultrasound score had a significant correlation with lung density (r=0.68) and percentage of hypoaerated lung (r=0.51). Median density and percentage of hypoaerated lung increased along the ultrasound patterns values (P<0.05) although not all patterns were significantly different from adjacent ones in the pairwise comparison. Interobserver variability in scoring of ultrasonographic patterns was moderate.
CONCLUSIONS: The pediatric lung ultrasound score correlates with lung density and percentage of hypoaerated lung measured with computed tomography.

KEY WORDS: Intensive care units, pediatric; Ultrasonography; Lung diseases; Diagnostic imaging

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