Lung Ultrasound in Pediatric Asthma - Characterizing Baseline Findings
Outside of Acute Exacerbations
Abstract
Background: Lung ultrasound (LUS) has been shown to be an effective tool
to rapidly diagnose certain causes of pediatric respiratory distress in
the emergency department. However, very little is known about LUS
findings in pediatric asthma outside of acute exacerbations. Objectives:
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. Methods: Eligible patients, aged 6 to
17 years old and diagnosed with asthma, underwent LUS during an
outpatient visit. LUS was conducted using a six-zone scanning protocol.
A positive LUS was defined by one or more of the following: ≥3 B-lines
per intercostal space, pulmonary consolidation and/or pleural anomaly.
Images were interpreted by an expert sonographer blinded to patient
clinical characteristics. Results: 52 patients were included. 10/52
patients had a positive LUS (19.2%, 95CI 8.3-30.1%). Of those with
positive LUS findings, 8 had B lines, 7 had consolidations
<1cm, 1 had a pleural line abnormality and 1 had a
consolidation >1cm. Positive findings were seen in the
right anterior and lateral zones in 60% of participants and were
limited to 1-2 intercostal spaces within one lung zone in 100% of
participants. Conclusion: To our knowledge, this is the first report of
LUS findings in outpatient pediatric asthma. Positive LUS findings in
asthmatic children can be seen outside of acute exacerbations. Such
findings need to be taken into consideration when using LUS for the
acute evaluation of a pediatric patient with asthma.