Lung POCUS valuable for predicting bronchiolitis severity in pediatric emergency settings

Acute bronchiolitis (AB) is infants' most common lower respiratory tract infection. The condition involves a series of inflammatory responses that leads to edema and bronchial congestion. Due to the risk of respiratory failure, patients in these cases require advanced airway support.

A study published in The American Journal of Emergency Medicine has concluded that Higher lung ultrasound (LUS)scores for AB are associated with increased respiratory support, longer length of stay (LOS) and more acute disposition. Using bedside LUS in the ED may assist the clinician in treating patients diagnosed with AB.

Objective scoring tools and plain film radiography have limited application. The diagnosis is clinical. Researchers studied the role of point-of-care lung ultrasound (LUS) in the present setting. They demonstrated associations with respiratory support at 12 and 24 hours, maximum respiratory support during hospitalization, disposition, and hospital length of stay.

Eighty-two subjects were enrolled, and the Physician performed LUS at the bedside. The lung was divided into 12 segments, and then the scanning, scoring, and summation were done in real-time based on the following categories: 0 – A-lines with less than 3 B lines per lung segment, 1 - having three or more B lines per lung segment but not consolidated, 2 - having consolidated B lines but no subpleural consolidation, and 3 - having subpleural consolidation with any findings scoring 1 or 2. A chart review was performed for all patients after their discharge from the hospital The categories for RS were RS (room air), low RS (wall O2 or heated high-flow nasal cannula <1 L/kg), and high RS (heated high-flow nasal cannula ≥1 L/kg or positive pressure).