Zoido Garrote Elia, García Aparicio Cristina, Camila Torrez Villarroel Constanza, Pedro Vega García Antonio, Muñiz Fontán Manoel, Oulego Erroz Ignacio
Servicio de Pediatría, Hospital de León, León, España.
Servicio de Pediatría, Hospital de León, León, España.
An Pediatr (Engl Ed). 2019 Jan;90(1):10-18. doi: 10.1016/j.anpedi.2018.03.002. Epub 2018 Apr 19.
To determine the correlation between the findings seen in early lung ultrasound with the clinical severity scales, and its association with the subsequent progression of the mild-moderate acute bronchiolitis (AB).
An observational prospective study conducted on infants with mild-moderate BA, using lung ultrasound in the first 24hours of hospital care. The lung involvement was graded (range 0-50 points) based on an ultrasound score (ScECO) and 2routinely used clinical scales: the modified Wood Downes Ferres (WDFM), and the Hospital Sant Joan de Deu (HSJD). The relationship between the ScECO and the subsequent clinical progression (admission to the Paediatric Intensive Care Unit (PICU), days in hospital, and days of oxygen therapy), was also determined.
The study included a total of 59 patients, with a median age of 90 days (IQR: 30-270 days). The median ScECO score was 6 points (2-8) in the patients that did not require hospital admission, with 9 points (5-13.7) admitted to the ward, and 17 (14.5-18) in the patients who needed to be transferred from the ward to the PICU (P=.001). The ScECO had a moderate lineal association with the WDFM scale (rho=0.504, P<.001) and the HSJD (rho=0.518; P<.001). The ScECO was associated with admission to PICU [OR 2.5 (95% CI: 1.1-5.9); P=.035], longer hospital stay [1.2 days 95% CI: 0.55-1.86); P=.001] and duration of oxygen therapy [0.87 days (95% CI: 0.26-1.48); P=.006].
There is a moderate correlation between early lung ultrasound findings with the severity of the AB evaluated by the clinical scales, as well as some relationship with the clinical progression.
确定早期肺部超声检查结果与临床严重程度量表之间的相关性，及其与轻度至中度急性细支气管炎（AB）后续病程的关联。
对轻度至中度AB患儿进行一项前瞻性观察研究，在住院治疗的头24小时内进行肺部超声检查。根据超声评分（ScECO）以及2种常用临床量表：改良的伍德·唐斯·费雷斯量表（WDFM）和圣琼·德迪乌医院量表（HSJD），对肺部受累情况进行分级（范围为0 - 50分）。还确定了ScECO与后续临床病程（入住儿科重症监护病房（PICU）、住院天数和吸氧天数）之间的关系。
该研究共纳入59例患者，中位年龄为90天（四分位间距：30 - 270天）。无需住院的患者ScECO评分中位数为6分（2 - 8分），入住病房的患者为9分（5 - 13.7分），需要从病房转至PICU的患者为17分（14.5 - 18分）（P = 0.001）。ScECO与WDFM量表（rho = 0.504，P < 0.001）和HSJD量表（rho = 0.518；P < 0.001）呈中度线性相关。ScECO与入住PICU相关[比值比2.5（95%可信区间：1.1 - 5.9）；P = 0.035]、住院时间延长[1.2天（95%可信区间：0.55 - 1.86）；P = 0.001]以及吸氧时间[0.87天（95%可信区间：0.26 - 1.48）；P = 0.006]。
早期肺部超声检查结果与通过临床量表评估的AB严重程度之间存在中度相关性，且与临床病程也存在一定关联。
