Pulmonary Medicine Unit, UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli, 8, 00168, Rome, Italy.
Emergency Department, University Hospital Cattinara, Trieste, Italy.
J Ultrasound. 2021 Jun;24(2):191-200. doi: 10.1007/s40477-020-00547-7. Epub 2021 Jan 6.
Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization.
Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted.
Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008).
USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP.
NCT03556488, June 14, 2018.
胸部超声是评估疑似社区获得性肺炎（CAP）患儿的一种非侵入性方法。我们评估了超声（US）空气支气管征变化在 CAP 管理中的预后作用，包括：复杂 CAP 的发生率、经验性抗生素治疗的改变、与退热时间的关系以及住院时间。
前瞻性纳入具有 CAP 和肺部实变放射影像学证据的患者。入院后 12 小时内和 48 小时进行胸部 US 检查。采用了一种基于空气支气管征存在和特征的新分级系统（USINCHILD 评分）。
根据 US 评分增加至少 1 级（Δ US 分级），即肺实变改善的表达，36 例患者被分为两组。48 小时后 Δ US 分级≥1 与复杂 CAP 的风险增加（p 值 0.027）和退热时间延长（p 值 0.036）相关。此外，Δ US 分级≥1 可预测住院时间缩短（p 值 0.008）。
USINCHILD 评分可能是儿科 CAP 管理的一种创新生物技术工具。
NCT03556488，2018 年 6 月 14 日。
