Related Experiment Video
Updated: Aug 12, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Use of lung ultrasound in school-aged children with wheezing
Marina Attanasi1, Simone Sferrazza Papa1, Annamaria Porreca2
1Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, University of Chieti-Pescara, Chieti, Italy.
Insights
Lung Ultrasound (LUS) effectively diagnoses wheezing in children, distinguishing between asthma and pneumonia. This safe, inexpensive bedside tool aids clinical decisions for pediatric respiratory infections.
Area of Science:
- Pediatric Pulmonology
- Medical Imaging
- Diagnostic Tools
Background:
- Limited bedside tools exist for diagnosing pediatric wheezing causes (asthma vs. pneumonia).
- Accurate diagnosis is crucial for appropriate treatment of acute respiratory infections in children.
Purpose of the Study:
- To characterize Lung Ultrasound (LUS) findings in school-aged children presenting with wheezing.
- To evaluate LUS utility in differentiating causes of wheezing and guiding follow-up treatment.
Main Methods:
- A cross-sectional study of 68 outpatients (mean age 9.9 years) with wheezing and suspected acute respiratory infection.
- Expert-performed LUS, blinded to clinical data, was conducted alongside spirometry.
- Pediatric Respiratory Assessment Measure (PRAM) score assessed symptom severity.
Main Results:
- Positive LUS findings (consolidation, B-lines, pleural abnormalities) were observed in 38.2% of patients.
- LUS correctly identified pneumonia (100% positive) and asthmatic bronchitis (57.7% positive), with 0% positivity in asthma.
- Positive LUS correlated with increased hospital admission, oxygen therapy, corticosteroid, and antibiotic use, and higher PRAM scores.
Conclusions:
- Lung Ultrasound (LUS) is a safe, cost-effective bedside tool for diagnosing pediatric wheezing.
- LUS aids clinicians in differentiating between pneumonia, asthmatic bronchitis, and asthma in children.
- The findings support LUS integration into the diagnostic workup for pediatric wheezing.
Background:
There is limited information available on fast and safe bedside tools that could help clinicians establish whether the pathological process underlying cases of wheezing is due to asthmatic exacerbation, asthmatic bronchitis, or pneumonia. The study's aim was to characterize Lung Ultrasound (LUS) in school-aged children with wheezing and evaluate its use for their follow-up treatment.
Materials And Methods:
We carried out a cross-sectional study involving 68 consecutive outpatients (mean age 9.9 years) with wheezing and suggestive signs of an acute respiratory infection. An expert sonographer, blinded to all subject characteristics, clinical course, and the study pediatrician's diagnosis, performed an LUS after spirometry and before BDT. The severity of acute respiratory symptoms was determined using the Pediatric Respiratory Assessment Measure (PRAM) score.
Results:
The LUS was positive in 38.2% (26/68) of patients [12 (46.1%) with multiple B-lines, 24 (92.3%) with consolidation, and 22 (84.6%) with pleural abnormalities]. In patients with pneumonia, asthmatic bronchitis, and asthma, the percentages of those patients with a positive LUS were 100%, 57.7%, and 0%, respectively. Of note, patients with a positive LUS were associated with an increased need for hospital admission (30.8% vs. 2.4%, p = 0.001), administration of oxygen therapy (14.6% vs. 0%, p = 0.009), oral corticosteroids (84.6% vs. 19.0%, p < 0.001), and antibiotics (88.5% vs. 11.9%, p < 0.001); and a higher median value of PRAM score (4.0 (2.0-7.0) vs. 2.0 (1.0-5.0); p < 0.001).
Conclusions:
Our findings would suggest the use of LUS as a safe and cheap tool used by clinicians to define the diagnosis of school-aged children with wheezing of unknown causes.
Related Concept Videos
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:28Physical Assessment of the Respiratory Tract IV: Auscultation
Breath Sounds
Breath sounds are categorized into vesicular, bronchovesicular, and bronchial.
01:31Respiratory System Abnormal Finding II: Palpation and Auscultation
Palpation Findings
During a respiratory assessment, palpation can reveal several vital abnormalities:
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...