Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospecti
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ORIGINAL ARTICLE
Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study Danilo Buonsenso 1,2 & Paolo Tomà 3 & Simona Scateni 4 & Antonietta Curatola 1 & Rosa Morello 1 & Piero Valentini 1,5 & Valentina Ferro 4 & Maria Luisa D’Andrea 4 & Nicola Pirozzi 4 & Anna Maria Musolino 4 Received: 11 December 2019 / Revised: 14 April 2020 / Accepted: 2 June 2020 / Published online: 21 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Lung ultrasound (US) in the evaluation of suspected pediatric pneumonia is increasingly used and has a recognized role in evaluating pleural effusions, although there are no detailed studies specifically addressing its use in the pediatric population. Objectives To define lung US findings of severe pediatric community-acquired pneumonia that required surgical procedures during admission. Materials and methods Our prospective case-control study compared lung US findings in patients ages 1 month to 17 years admitted with community-acquired pneumonia that required surgical procedures from findings those who did not. Lung US was performed at admission and always before surgical procedures. Medical treatment, laboratory and microbiological findings, chest X-ray, computed tomography scan and surgical procedures are described. Results One hundred twenty-one children with community-acquired pneumonia were included; of these, 23 underwent surgical intervention. Compared with the control group, children requiring a surgical procedure had a significantly higher rate of large consolidations (52.2%; 95% confidence interval [CI]: 30.6% to 73.2%), larger and complicated pleural effusions (100%; 95% CI: 85.2% to 100%), and both liquid and air bronchograms (73.9%; 95% CI: 51.6% to 89.8%). Conclusion Larger consolidations, larger and more complicated pleural effusions, and liquid and air bronchograms were associated with surgical treatment. Keywords Adolescents . Case-control study . Children . Community-acquired pneumonia . Complicated pneumonia . Lung . Pneumonia . Ultrasound
Introduction * Danilo Buonsenso [email protected] 1
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2
Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy
3
Department of Radiology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
4
Emergency Department, Ospedale Pediatrico Bambino Gesù, Rome, Italy
5
Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy
Community-acquired pneumonia is one of the leading causes of pediatric morbidity and mortality worldwide [1–4]. Although the overall burden of pediatric communityacquired pneumonia has been reduced over the last decade [5], on average 1/66 children in high-income countries and 1/5 in low- and middle-income countries are still affected by it every year.
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