Point of care lung ultrasound of children with acute asthma exacerbations in the pediatric ED.
Am J Emerg Med
; 35(4): 615-622, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-28063721
ABSTRACT
OBJECTIVES:
Primary objective was to characterize lung ultrasound findings in children with asthma presenting with respiratory distress to the emergency department (ED). Secondary objectives included correlating these findings with patients' clinical course in the ED.METHODS:
Eligible patients 2-17years of age, underwent a lung ultrasound by the study sonographer between November 2014 to December 2015. Positive lung ultrasound was defined as the presence of ≥1 of the followingfindings:
≥3 B-lines per intercostal space, consolidation and/or pleural abnormalities. The treating physician remained blinded to ultrasound findings; clinical course was extracted from the medical chart.RESULTS:
A total of sixty patients were enrolled in this study. Lung ultrasound was positive in 45% (27/60) of patients B-line pattern in 38%, consolidation in 30% and pleural line abnormalities in 12%. A positive lung ultrasound correlated with increased utilization of antibiotics (26% vs 0%, p=0.03), prolonged ED length of stay (30% vs. 9%, p=0.04) and admission rate (30% vs 0%, p=0.03). Inter-rater agreement between novice and expert sonographers was excellent with a kappa of 0.92 (95% CI 0.84-1.00).CONCLUSIONS:
This study characterized lung ultrasound findings in pediatric patients presenting with acute asthma exacerbations; nearly half of whom had a positive lung ultrasound. Positive lung ultrasounds were associated with increased ED and hospital resource utilization. Future prospective studies are needed to determine the utility and reliability of this tool in clinical practice.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Asma
/
Dispneia
/
Pulmão
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
Am J Emerg Med
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Canadá