Abstract
Objective: We sought to characterize point-of-care lung
ultrasound (LUS) findings in children with asthma exacerbations and to
determine whether the presence and magnitude of findings were associated
with asthma severity. Methods: We enrolled a convenience sample
of patients aged 5-18 years presenting with acute asthma exacerbation to
a tertiary care pediatric emergency department. Severity of an asthma
exacerbation (mild, moderate, severe) was assessed within 1-hour of the
LUS using the Hospital Asthma Severity Score, a validated asthma
assessment tool. LUS was performed by trained pediatric emergency
providers . The presence of LUS findings (any B-lines, ≥3
B-lines per view, consolidations, pleural effusion and pleural line
abnormalities) was assessed using a standardized criterion.
Results: A total of 111 patients with a median age of 8 years
(IQR 6, 12) were enrolled. LUS was positive in 57% of patients. Pleural
line abnormalities were observed in 34%, B-lines in 29%,
consolidations <1cm in 24%, and consolidations ≥1cm in 7 %.
Patients with moderate and severe asthma exacerbations were more likely
to have any B-lines (31% and 43%, respectively) than patients with
mild exacerbations (12%; p= 0.021), however the presence of ≥3 B-lines
did not differ across severity groups. The presence of other findings
did not differ based upon asthma severity. Conclusions: LUS
findings are commonly observed in patients presenting with asthma
exacerbations. While B-lines were more likely to be found in
exacerbations of higher severity, LUS findings associated with pediatric
pneumonia did not correlate with severity. These findings provide
valuable information for the diagnostic use of LUS.