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Application of dynamic air bronchograms on lung ultrasound to diagnose pneumonia in undifferentiated respiratory distress.

ABSTRACT: Patients presenting with undifferentiated respiratory distress remain a diagnostic dilemma. The use of point-of-care ultrasound (POCUS) to evaluate the lungs and pleural cavities can improve diagnostic uncertainty in these patients. When visualizing consolidated lung tissue with POCUS, one may encounter static or dynamic air bronchograms. Static air bronchograms are seen in atelectasis and pneumonia, whereas dynamic air bronchograms are highly specific for pneumonia. We describe a case of a critically ill patient where bedside thoracic ultrasound helped to narrow the differential diagnosis early in the resuscitation, while standard radiographs were non-diagnostic.

SUBMITTER: Shah A

PROVIDER: S-EPMC9356263 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Application of dynamic air bronchograms on lung ultrasound to diagnose pneumonia in undifferentiated respiratory distress.

Shah Aalap A Oliva Cynthia C Stem Christopher C Cummings Earl Quinn EQ

Respiratory medicine case reports 20220730

Patients presenting with undifferentiated respiratory distress remain a diagnostic dilemma. The use of point-of-care ultrasound (POCUS) to evaluate the lungs and pleural cavities can improve diagnostic uncertainty in these patients. When visualizing consolidated lung tissue with POCUS, one may encounter static or dynamic air bronchograms. Static air bronchograms are seen in atelectasis and pneumonia, whereas dynamic air bronchograms are highly specific for pneumonia. We describe a case of a crit ...[more]

PMID: 35942001

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Project description:BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, lung ultrasonography (US) has been gaining importance in pediatric intensive care and emergency settings for the screening, diagnosis, and monitoring of pulmonary pathology.PurposeTo describe the pattern of lung US changes in patients with COVID-19 pneumonia and its potential role in monitoring ventilated patients.MethodsThis prospective observational study included children aged 1 month to 12 years with a confirmed diagnosis of COVID-19. Lung US was performed using a high-frequency linear probe (5-12 MHz) in all children with moderate/severe respiratory symptoms within 24 hours of admission and then daily until the patient required oxygen therapy. Lung involvement severity was assessed using lung US scores, while lung aeration improvement or deterioration was measured using lung ultrasound reaeration scores (LUSReS).ResultsOf 85 children with moderate to severe disease, 54 with pulmonary disease were included. Of them, 50 (92.5%) had an interstitial pattern, followed by pleural line abnormalities in 44 (81.5%), reduced or absent lung sliding in 31 (57.4%), and consolidation in 28 (51.8%). A significantly higher lung US score (median, 18; interquartile range [IQR], 11-22) was observed in ventilated versus nonventilated patients (median, 9; IQR, 6-11). LUSReS improvement after positive end-expiratory pressure titration was positively correlated with improved dynamic lung compliance and oxygenation indices and negatively correlated with the requirement for driving pressure. Successful weaning could be predicted with 100% specificity if loss of LUSReS ≤ 5.ConclusionInterstitial syndrome, fragmented pleural line, and subpleural microconsolidation were the most prevalent lung US findings in children with COVID-19 pneumonia. Thus, lung US may have the ability to monitor changes in lung aeration caused by mechanical ventilation and predict its successful weaning in children with COVID-19.

Dataset Information

Application of dynamic air bronchograms on lung ultrasound to diagnose pneumonia in undifferentiated respiratory distress.

Publications

Application of dynamic air bronchograms on lung ultrasound to diagnose pneumonia in undifferentiated respiratory distress.

Similar Datasets

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