Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study

• Published in: Pediatric radiology Vol. 50; no. 11; pp. 1560 - 1569
• Main Authors: Buonsenso, Danilo, Tomà, Paolo, Scateni, Simona, Curatola, Antonietta, Morello, Rosa, Valentini, Piero, Ferro, Valentina, D’Andrea, Maria Luisa, Pirozzi, Nicola, Musolino, Anna Maria
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2020; Springer Nature B.V
• Subjects: Children; Computed tomography; Confidence intervals; Imaging; Lungs; Medical treatment; Medicine; Medicine & Public Health; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Pediatrics; Pneumonia; Radiology; Surgical equipment; Teenagers; Ultrasonic imaging; Ultrasound; Complicated pneumonia; Pneumonia; Lung; Case-control study; Children; Community-acquired pneumonia; Adolescents; Ultrasound
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-020-04750-w

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.