Department of Pediatrics, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
UP Centre for Pediatric Emergencies, Montreal, Quebec, Canada.
Pediatr Pulmonol. 2022 Oct;57(10):2474-2480. doi: 10.1002/ppul.26061. Epub 2022 Jul 12.
Lung ultrasound (LUS) has been shown to be an effective tool to rapidly diagnose certain causes of pediatric respiratory distress. However, very little is known about LUS findings in pediatric asthma.
The primary objective of this study was to characterize LUS findings in a cohort of pediatric patients with a definitive diagnosis of asthma, outside of an asthma exacerbation.
Eligible patients, aged 6-17 years old and diagnosed with asthma, underwent LUS during an outpatient visit. LUS was conducted using a six-zone scanning protocol. Presence of a LUS artifact was defined by one or more of the following: ≥3 B-lines per intercostal space, pulmonary consolidation, and/or pleural abnormality. Images were interpreted by an expert sonographer blinded to patient clinical characteristics.
Fifty-two patients were included. 10/52 (19.2%) patients demonstrated the presence of LUS artifacts: 8 with ≥3 B-lines, 1 with consolidation >1 cm, and 7 with subpleural consolidations <1 cm, 1 with a pleural line abnormality. Artifacts were seen in the right anterior and lateral zones in 60% of participants and were limited to 1-2 intercostal space(s) within one lung zone in all participants. No association was found between presence of LUS artifacts and asthma control or severity.
To our knowledge, this is the first report of LUS findings in outpatient pediatric asthma. LUS artifacts in asthmatic children can be seen outside of acute exacerbations. Such baseline findings need to be taken into consideration when using LUS for the acute evaluation of a pediatric patient with asthma.
肺部超声（LUS）已被证明是一种快速诊断小儿呼吸窘迫某些病因的有效工具。然而，对于小儿哮喘的 LUS 表现知之甚少。
本研究的主要目的是描述在哮喘缓解期之外，经明确诊断为哮喘的儿科患者队列中 LUS 的表现。
符合条件的患者年龄在 6-17 岁之间，被诊断为哮喘，在门诊就诊期间接受 LUS 检查。LUS 使用六区扫描方案进行。LUS 伪影的存在定义为以下一种或多种情况：每个肋间空间有≥3 条 B 线、肺部实变和/或胸膜异常。图像由一位专家超声医师进行解读，该医师对患者的临床特征不知情。
共纳入 52 例患者。52 例患者中有 10 例（19.2%）存在 LUS 伪影：8 例存在≥3 条 B 线，1 例存在>1cm 的实变，7 例存在<1cm 的胸膜下实变，1 例存在胸膜线异常。60%的患者在前侧和外侧区可见伪影，所有患者的伪影均局限于一个肺区的 1-2 个肋间。LUS 伪影的存在与哮喘控制或严重程度之间没有关联。
据我们所知，这是第一篇关于门诊小儿哮喘 LUS 表现的报告。哮喘儿童在急性发作期之外也可出现 LUS 伪影。在使用 LUS 对哮喘急性发作的儿科患者进行评估时，需要考虑到这种基线表现。
