Utility of Lung Ultrasound Assessment in Infants with Acute Bronchiolitis: An Observational Study

To assess the utility of Lung ultrasound (LUS) in predicting clinical outcomes and disease severity in infants with acute bronchiolitis.

Infants with acute bronchiolitis underwent clinical assessment using the ReSVinet score and LUS to assess B-lines, intercostal space involvement, and sub-pleural consolidations. Nasopharyngeal swabs identified the viral etiology. Outcomes including ICU admission, length of hospital stay, and oxygen/advanced respiratory support were recorded and analyzed.

One hundred (100) infants were enrolled with a mean age of 8.04±6.5 mo. On admission, the clinical severity score (ReSVinet) classified 64 infants as having moderate and 36 as having severe bronchiolitis. RSV was the viral pathogen detected in 23% of infants. LUS assessment categorized 28 infants as mild, 41 as moderate, and 31 as severe, showing a strong correlation with clinical severity scores (r = 0.8, p <0.001). Among severe LUS cases, 75% required ICU admission (p <0.001). Hospital stay increased with LUS severity (5.79 ± 1.4 vs. 7.80 ± 2.8 vs. 10.87 ± 2.8 d for mild, moderate, and severe; p <0.01), as did oxygen/advanced respiratory support needs (χ², p <0.001). LUS showed predictive ability for ICU admission (AUC 0.906; CI 0.851-0.961; p <0.001) 77.6% sensitivity, 95.8% specificity, 98.3% PPV and 57.5% NPV. Clinical severity (ReSVinet score) was comparable; its AUC was 0.891 (CI: 0.831-0.952), 75% sensitivity and 100% specificity, 100% PPV and 55.8% NPV.

LUS is a useful tool for early risk stratification in acute bronchiolitis.