Lung Ultrasound Pattern in Healthy Infants During the First 6 Months of Life.
B-lines
healthy infants
lung ultrasound
Journal
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
ISSN: 1550-9613
Titre abrégé: J Ultrasound Med
Pays: England
ID NLM: 8211547
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
25
03
2020
revised:
28
04
2020
accepted:
30
04
2020
pubmed:
30
5
2020
medline:
15
5
2021
entrez:
30
5
2020
Statut:
ppublish
Résumé
Lung ultrasound (LUS) has gained a primary role in the diagnosis and management of pleuropulmonary disorders in pediatric practice. However, normal and pathologic patterns are translated from adult studies and have never been specifically studied in children, particularly in infants. This was a prospective observational pilot study aiming to define the normal LUS pattern in healthy infants during the first 6 months of life. We recruited healthy neonates at 7 to 10 days of life, and these were followed until the sixth month of life (times: 7-10 days, 1 month, 3 months, and 6 months). We excluded neonates with a gestational age before 33 weeks and neonates with cardiac or lung abnormalities or diseases, immune deficiencies, metabolic or genetic conditions, and acute or chronic respiratory diseases. A LUS evaluation was performed by a single certified pediatrician. The chest wall was examined in 18 areas, addressing A-lines, short and long B-lines, pleural abnormalities, and subpleural consolidations. Thirty-seven neonates were enrolled and followed until the sixth month of life, 27 (73%) of whom were born at term (≥37 weeks) and 10 (27%) of whom were born preterm (33-36 weeks). Most of the patients at 7 to 10 days showed multiple B-lines (long and short) with a progressive normalization toward a normal A pattern at 6 months (P < .00001; 95% confidence interval, 13.75-23.24). No infants showed subpleural consolidations or pleural abnormalities. This study has implications for the interpretation of LUS during the first 6 months of life. Most healthy infants show a diffuse pattern of vertical artifacts (B-lines), and the LUS pattern tends to be similar to the physiologic pattern (A-lines) after the sixth month of life. The only pathologic LUS findings were pleural irregularities and effusion and subpleural consolidations, which have never been described in healthy infants.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2379-2388Informations de copyright
© 2020 American Institute of Ultrasound in Medicine.
Références
Stadler JA, Andronikou S, Zar HJ. Lung ultrasound for the diagnosis of community-acquired pneumonia in children. Pediatr Radiol 2017; 47:1412-1419.
Rea G, Sperandeo M, Di Serafino M, Vallone G, Tomà P. Neonatal and pediatric thoracic ultrasonography. J Ultrasound 2019; 22:121-130.
Pereda MA, Chavez MA, Hooper-Miele CC, et al. Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics 2015; 135:714-722.
Liu J, Lovrenski J, Ye Hlaing A, Kurepa D. Neonatal lung diseases: lung ultrasound or chest X-ray. J Matern Fetal Neonatal Med 2019; 20:1-6.
Supino MC, Buonsenso D, Scateni S, et al. Point-of-care lung ultrasound in infants with bronchiolitis in the pediatric emergency department: a prospective study. Eur J Pediatr 2019; 178:623-632.
Burri PH. Fetal and postnatal development of the lung. Annu Rev Physiol 1984; 46:617-628.
Wahlgren H, Mortensson W, Eriksson M, et al. Radiological findings in children with acute pneumonia: age more important than infectious agent. Acta Radiol 2005; 46:431-436.
Demi L, van Hoeve W, van Sloun RJG, Soldati G, Demi M. Determination of a potential quantitative measure of the state of the lung using lung ultrasound spectroscopy. Sci Rep 2017; 7:12746.
Soldati G, Smargiassi A, Inchingolo R, et al. Lung ultrasonography may provide an indirect estimation of lung porosity and air space geometry. Respiration 2014; 88:458-468.
Soldati G, Inchingolo R, Smargiassi A, et al. Ex vivo lung sonography: morphologic-ultrasound relationship. Ultrasound Med Biol 2012; 38:1169-1179.
Volpicelli G, Elbarbary M, Blaivas M, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for the International Consensus Conference on Lung Ultrasound (ICC-LUS): international evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 2012; 38:577-591.
Demi M, Prediletto R, Soldati G, Demi L. Physical mechanisms providing clinical information from ultrasound lung images: hypotheses and early confirmations. IEEE Trans Ultrason Ferroelectr Freq Control 2019; 67:612-623.
Soldati G, Demi M, Inchingolo R, Smargiassi A, Demi L. On the physical basis of pulmonary sonographic interstitial syndrome. J Ultrasound Med 2016; 35:2075-2086.
Soldati G, Demi M, Smargiassi A, Inchingolo R, Demi L. The role of ultrasound lung artifacts in the diagnosis of respiratory diseases. Expert Rev Respir Med 2019; 13:163-172.
Lichtenstein DA. Ultrasound in the management of thoracic disease. Crit Care Med 2007; 35(suppl):S250-S261.
Gori L. Lung ultrasound in infants with bronchiolitis: a multicentric prospective study. Paper presented at: National Congress of the Italian Academy of Thoracic Ultrasound; 2020; Bolzano, Italy.
Buonsenso D. Lung ultrasound in healthy infants. Paper presented at: National Congress of the Italian Academy of Thoracic Ultrasound; 2020; Bolzano, Italy.
Gori L, Amendolea A, Soldati G. Observational, prospective, multicentre, non-profit study on the usefulness of lung ultrasound in the management of bronchiolitis in the paediatric population aged ≤12 months. Paper presented at: Lung Ultrasound in Neonates and Children Congress; 2019; Paris, France.
Goffi A, Kruisselbrink R, Volpicelli G. The sound of air: point-of-care lung ultrasound in perioperative medicine. Can J Anaesth 2018; 65:399-416.
Mullassery D, Smith NP. Lung development. Semin Pediatr Surg 2015; 24:152-155.
Rackley CR, Stripp BR. Building and maintaining the epithelium of the lung. J Clin Invest 2012; 122:2724-2730.
Herring MJ, Putney LF, Wyatt G, Finkbeiner WE, Hyde DM. Growth of alveoli during postnatal development in humans based on stereological estimation. Am J Physiol Lung Cell Mol Physiol 2014; 307:L338-L344.
Narayanan M, Owers-Bradley J, Beardsmore CS, et al. Alveolarization continues during childhood and adolescence: new evidence from helium-3 magnetic resonance. Am J Respir Crit Care Med 2012; 185:186-191.
Nikolić MZ, Sun D, Rawlins EL. Human lung development: recent progress and new challenges. Development 2018; 145:145-176.
Schittny JC. Development of the lung. Cell Tissue Res 2017; 367:427-444.
Najgrodzka P, Buda N, Zamojska A, Marciniewicz E, Lewandowicz-Uszyńska A. Lung ultrasonography in the diagnosis of pneumonia in children-a meta-analysis and a review of pediatric lung imaging. Ultrasound Q 2019; 35:157-163.
Buonsenso D, Brancato F, Valentini P, Curatola A, Supino M, Musolino AM. The use of lung ultrasound to monitor the antibiotic response of community-acquired pneumonia in children: a preliminary hypothesis. J Ultrasound Med 2019; 39:817-826.
Musolino AM, Tomà P, Supino MC, et al. Lung ultrasound features of children with complicated and noncomplicated community acquired pneumonia: a prospective study. Pediatr Pulmonol 2019; 54:1479-1486.
Basile V, Di Mauro A, Scalini E, et al. Lung ultrasound: a useful tool in diagnosis and management of bronchiolitis. BMC Pediatr 2015; 15:63.
Di Mauro A, Ammirabile A, Quercia M, et al. Acute bronchiolitis: is there a role for lung ultrasound? Diagnostics (Basel) 2019; 9:E172.
Kurepa D, Zaghloul N, Watkins L, Liu J. Neonatal lung ultrasound exam guidelines. J Perinatol 2018; 38:11-22.