Measurement of the interbronchial angle in acute viral bronchiolitis.
interbronchial angle
respiratory syncytial virus
viral bronchiolitis
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
27 Nov 2023
27 Nov 2023
Historique:
revised:
09
11
2023
received:
31
03
2021
accepted:
14
11
2023
medline:
27
11
2023
pubmed:
27
11
2023
entrez:
27
11
2023
Statut:
aheadofprint
Résumé
Acute viral bronchiolitis (AVB) is the most common lower airway infection in children under 2 years. Attempts to determine disease severity based on clinical and radiological manifestations are a major challenge. Measurements of the anatomy of the trachea and main bronchi are not only limited to pure anthropometry, but are also useful for better care of critically ill patients. The purpose of the study is to verify the association between measurements of the interbronchial angle (ITB) and the severity of respiratory disease. A cross-sectional study, which included all patients admitted to the Santo Antônio Children's Hospital, over a period of 1 year, with diagnosis of AVB by respiratory syncytial virus (RSV) was designed. ITB angle was measured and clinical characteristics were analyzed. Quantitative variables were compared and correlation analysis was performed using Pearson's correlation coefficient. A receiving operator characteristic (ROC) curve was performed. P-value <0.05 was statistically significant. A total of 425 patients with AVB due to RSV were included. Most of these patients were male and the median age was 130 days, 91.11% of them required oxygen therapy through a nasal catheter, 3.3% used noninvasive ventilation and 4% used mechanical ventilation. Those who required MV or NIV and intensive care unit support were considered severe. The mean ITB was lower for these patients than for those of lesser severity (p < 0.05). The present study demonstrates that there is an association between ITB and AVB severity. The smaller the ITB, the greater the disease severity.
Sections du résumé
BACKGROUND
BACKGROUND
Acute viral bronchiolitis (AVB) is the most common lower airway infection in children under 2 years. Attempts to determine disease severity based on clinical and radiological manifestations are a major challenge. Measurements of the anatomy of the trachea and main bronchi are not only limited to pure anthropometry, but are also useful for better care of critically ill patients. The purpose of the study is to verify the association between measurements of the interbronchial angle (ITB) and the severity of respiratory disease.
METHODS
METHODS
A cross-sectional study, which included all patients admitted to the Santo Antônio Children's Hospital, over a period of 1 year, with diagnosis of AVB by respiratory syncytial virus (RSV) was designed. ITB angle was measured and clinical characteristics were analyzed. Quantitative variables were compared and correlation analysis was performed using Pearson's correlation coefficient. A receiving operator characteristic (ROC) curve was performed. P-value <0.05 was statistically significant.
RESULTS
RESULTS
A total of 425 patients with AVB due to RSV were included. Most of these patients were male and the median age was 130 days, 91.11% of them required oxygen therapy through a nasal catheter, 3.3% used noninvasive ventilation and 4% used mechanical ventilation. Those who required MV or NIV and intensive care unit support were considered severe. The mean ITB was lower for these patients than for those of lesser severity (p < 0.05).
CONCLUSION
CONCLUSIONS
The present study demonstrates that there is an association between ITB and AVB severity. The smaller the ITB, the greater the disease severity.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : None
Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
O'Brien S, Borland ML, Cotterell E, et al. Australasian bronchiolitis guideline. J Paediatr Child Health. 2019;55(1):42-53. doi:10.1111/jpc.14104
Zorc JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics. 2010;125:342-349.
Nair H, Nokes DJ, Gessner BD, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545-1555.
Miller EK, Gebretsadik T, Carroll KN, et al. Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J. 2013;32:950-955.
Hasegawa K, Jartti T, Mansbach JM, et al. Respiratory syncytial virus genomic load and disease severity among children hospitalized with bronchiolitis: multicenter cohort studies in the United States and Finland. J Infect Dis. 2015;211:1550-1559.
Scagnolari C, Midulla F, Selvaggi C, et al. Evaluation of viral load in infants hospitalized with bronchiolitis caused by respiratory syncytial virus. Med Microbiol Immunol. 2012;201:311-317.
Jha A, Jarvis H, Fraser C, et al. Respiratory syncytial virus. Eur Respir Soc Monogr. 2016;72:84-109.
Collins PL, Fearns R, Graham BS. Respiratory syncytial virus: virology, reverse genetics, and pathogenesis of disease. Curr Top Microbiol Immunol. 2013;372:3-38.
Galante D. Tracheobronchial angles in children: can it change during anesthesia? Pediatric Anesthesia. 2018;28(9):826. doi:10.1111/pan.13457
Winningham PJ, Martínez-Jiménez S, Rosado-de-Christenson ML, Betancourt SL, Restrepo CS, Eraso A. Bronchiolitis: a practical approach for the general radiologist. Radiographics. 2017;37(3):777-794. doi:10.1148/rg.2017160131
Adriani J, Griggs TS. An improved endoteacheal tube for pediatric use. Anesthesiology. 1954;15:466-470.
Onoe R, Yamashiro T, Handa H, et al. 3D-measurement of tracheobronchial angles on inspiratory and expiratory chest CT in COPD: respiratory changes and correlation with airflow limitation. Int J Chronic Obstruct Pulm Dis. 2018;13:2399-2407. doi:10.2147/COPD.S165824
Wani TM, Buchh B, AlGhamdi FS, Jan R, Tumin D, Tobias JD. Tracheobronchial angles in children: three-dimensional computed tomography-based measurements. Pediatric Anesthesia. 2018;28(5):463-467. doi:10.1111/pan.13377
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-163. doi:10.1016/j.jcm.2016.02.012
Taskin V. Tracheal carinal angle and left atrial size. Arch Intern Med. 1991;151(2):307-308.
Cleveland RH. Symmetry of bronchial angles in children. Radiology. 1979;133(1):89-93. doi:10.1148/133.1.89
Florin TA, Plint AC, Zorc JJ. Viral bronchiolitis. Lancet. 2017;389(10065):211-224. doi:10.1016/S0140-6736(16)30951-5
Kern S, Uhl M, Berner R, Schwoerer T, Langer M. Respiratory syncytial virus infection of the lower respiratory tract: radiological findings in 108 children. Eur Radiol. 2001;11(12):2581-2584. doi:10.1007/s003300100887
Prodhan P, Westra SJ, Lin J, Karni-Sharoor S, Regan S, Noviski N. Chest radiological patterns predict the duration of mechanical ventilation in children with RSV infection. Pediatr Radiol. 2009;39(2):117-123. doi:10.1007/s00247-008-1042-3
Friis B, Eiken M, Hornsleth A, Jensen A. Chest X-ray appearances in pneumonia and bronchiolitis. Correlation to virological diagnosis and secretory bacterial findings. Acta Paediatr. 1990;79(2):219-225. doi:10.1111/j.1651-2227.1990.tb11442.x
Rius Peris JM, Maraña Pérez AI, Valiente Armero A, et al. La radiografía de tórax en la bronquiolitis aguda: calidad técnica, hallazgos y evaluación de su fiabilidad. Anales de Pediatría. 2021;94(3):129-135. doi:10.1016/j.anpedi.2020.03.011
Simpson W, Hacking PM, Court SDM, Gardner PS. The radiological findings in respiratory syncytial virus infection in children. Part I. Definitions and interobserver variation in the assessment of abnormalities on the chest X-ray. Pediatr Radiol. 1974;2(2):97-100. doi:10.1007/BF01314938