Minerva Anestesiologica 2021 Feb 17

DOI: 10.23736/S0375-9393.21.15155-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

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

BACKGROUND: Lung ultrasound can be used to assess lung density and aeration at the bedside. A 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 6 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 (ρ = 0.68) and percentage of hypoaerated lung (ρ = 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