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[Chest radiograph in bronchiolitis: is it always necessary?]
María L García García1, C Calvo Rey, S Quevedo Teruel
1Servicios de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, Spain. marialuzgarcia@terra.es
Anales De Pediatria (Barcelona, Spain : 2003)
|October 8, 2004
Summary
Routine chest X-rays for infants with bronchiolitis are often unnecessary. Fever and low oxygen saturation are key indicators for potential infiltrate/atelectasis, guiding the need for radiological investigation in pediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Pediatric Pulmonology
- Diagnostic Imaging
Background:
- Routine chest radiography in infants with bronchiolitis increases healthcare costs.
- Unnecessary radiation exposure is a concern for pediatric patients.
Purpose of the Study:
- Evaluate the prevalence of infiltrate/atelectasis in infants with bronchiolitis.
- Assess the impact of chest radiograph results on patient management.
- Identify clinical predictors for normal chest radiographs to reduce unnecessary imaging.
Main Methods:
- Prospective study of 252 infants (<24 months) diagnosed with bronchiolitis.
- Data collected: age, sex, onset, respiratory rate, temperature, oxygen saturation, auscultation findings, and identified virus.
- Chest radiograph findings and changes in management before and after results were analyzed.
Main Results:
- Infiltrate/atelectasis found in 14.3% of infants.
- Fever (≥38°C) and hypoxia (<94% O2 saturation) were associated with infiltrate/atelectasis.
- Patient management changed in 30% of cases with infiltrate/atelectasis.
- Normal chest radiographs predicted in 92% of infants with normal temperature and oxygen saturation.
Conclusions:
- Most infants with bronchiolitis have normal chest radiographs.
- Fever and hypoxia are significant predictors of infiltrate/atelectasis.
- Absence of fever and hypoxia can reliably predict normal chest radiographs, supporting reduced imaging.