McGill University Health Center, Division of General Pediatrics, Montreal Children's Hospital, Montreal, Quebec, Canada.
Division of Pediatric Emergency Medicine, Children's Hospital of Eastern Ontario, Ontario, Ottawa, Canada.
Pediatr Pulmonol. 2022 Jun;57(6):1475-1482. doi: 10.1002/ppul.25907. Epub 2022 Apr 13.
Lung ultrasound (LUS) has been shown to be a useful clinical tool in pediatrics, but very little is known about the LUS findings of asthma in children.
The primary objective was to characterize LUS findings of pediatric patients before and after a chemically induced bronchospasm. The secondary objective was to evaluate the effect of bronchodilators on LUS findings.
Eligible children 6-17 years old presenting for a methacholine challenge test (MCT) in a pediatric respiratory clinic were recruited. Patients with viral symptoms were excluded. A six-zone LUS protocol was performed before and after the MCT, and after bronchodilator administration; video recordings were analysed by an expert blinded to the patient characteristics and MCT results.
Forty-four patients were included in the study. Five patients had positive LUS findings at baseline. Nine patients out of 29 (31%) had new-onset positive LUS following a reactive MCT. There was a significant association between having a chemically induced bronchospasm and a positive LUS post-MCT (odds ratio [95% confidence interval]: 5.3 [1.0-27.7]; p = 0.05). Among patients who developed positive LUS findings post-MCT, four out of nine returned to having a negative LUS postbronchodilator administration.
This is the first known report of an association between LUS findings and bronchospasm in pediatric patients. It is also the first documentation of resolution of LUS findings postbronchodilator administration. Most LUS findings observed were small and limited to a few intercostal spaces. Further research is required to quantify these findings and evaluate the effect of salbutamol on LUS.
肺部超声（LUS）已被证明在儿科中是一种有用的临床工具，但对于儿童哮喘的 LUS 表现知之甚少。
主要目的是描述化学诱导支气管痉挛前后儿科患者的 LUS 表现。次要目的是评估支气管扩张剂对 LUS 表现的影响。
在儿科呼吸科进行乙酰甲胆碱激发试验（MCT）的 6-17 岁符合条件的患儿被招募。排除有病毒症状的患者。在 MCT 前后以及支气管扩张剂给药后进行六区 LUS 检查；视频记录由一位对患者特征和 MCT 结果均不知情的专家进行分析。
共有 44 名患者纳入研究。5 名患者在基线时有阳性 LUS 表现。29 名患者中有 9 名（31%）在反应性 MCT 后出现新的阳性 LUS。化学诱导性支气管痉挛与 MCT 后阳性 LUS 之间存在显著相关性（比值比[95%置信区间]：5.3 [1.0-27.7]；p=0.05）。在 MCT 后出现阳性 LUS 表现的患者中，有 4 名在支气管扩张剂给药后恢复为阴性 LUS。
这是首次报道 LUS 表现与儿科患者支气管痉挛之间存在关联。这也是首次记录支气管扩张剂给药后 LUS 表现消退。观察到的大多数 LUS 表现为小范围，局限于几个肋间空间。需要进一步研究来量化这些发现并评估沙丁胺醇对 LUS 的影响。
