Special topics in lung ultrasound in children
Authors:
V. Zoľák 1; S. Nosáľ 1; B. Zoľáková 2; M. Fedor 1; M. Janíková 1
Authors place of work:
Klinika detskej anestéziológie a intenzívnej medicíny JLF UK a UNM, Martin
prednosta doc. MUDr. S. Nosáľ, PhD.
1; Neonatologická klinika JLF UK a UNM, Martin
prednosta prof. MUDr. M. Zibolen, PhD.
2
Published in the journal:
Čes-slov Pediat 2015; 70 (5): 259-266.
Category:
Original Papers
Summary
Objective:
Lung ultrasound (LUS) is one of the newest imaging method currently used in diagnostics of respiratory diseases. Simplicity, feasibility and high reliability of LUS designates this method for common clinical practice.
Aims:
To define lung ultrasound specifics for children, comparison of 3 ultrasound probes, definition of physiologic image of lungs in healthy children (“physiologic B lines”), comparison of LUS images in ventilated and non-ventilated children, calculation of sensitivity and specificity for pneumonia, atelectasis, ARDS, bronchiolitis and pleural effusions diagnosed by LUS.
Methods:
135 children included in study, 45 children in research group, 90 children in control group (of them 62 healthy children and 28 critically ill children without respiratory pathology).
Results:
We have not achieved statistical significance in comparison of 10 basic lung signs and artifacts (Pearson`s chi-square test, p=0.1–0.687) between adult and pediatric LUS. By interobserver analysis we found out absolute inadequacy of microconvex array in pediatric LUS (concordance with linear 15.56% and convex 11.76% of cases). In all children from control group only physiological images were obtained, but we were also able to detect literature described “physiologic B-line” in control group (in 38.7% healthy children, and 28.5% in critically ill children without lung pathology). In several children we have detected “physiologic B-line” in more than 1 examined areas. We did not show significant difference in distribution of such a B-lines (p>0.05). In analysis of LUS images in ventilated and non-ventilated patients (examined before and after weaning) we did not determine statistically significant difference p=0.744–1.0. We calculated sensitivity and specificity of LUS in pneumonia (94.74% and 98.04%), bronchiolitis (89.29% and 98.04%), atelectasis (83.33% and 97.09%), lung contusion (91.84% and 98.04%) and pleural effusions (93.1% and 95.24%) in children.
Conclusion:
We manifested the unique role of lung ultrasound in clinical environment in diagnosis of respiratory diseases in children. In comparison with adult medicine several differences and specifics exist for pediatric population.
Key words:
lung ultrasonography, children, respiratory diseases, pneumonia, lung contusion
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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