Lung ultrasound systematic review shows its prognostic and diagnostic role in acute viral bronchiolitis

Acta Paediatr. 2023 Feb;112(2):222-232. doi: 10.1111/apa.16578. Epub 2022 Oct 31.

Abstract

Aim: Lung ultrasound (LUS) has not been included in the current guidelines for the diagnosis of bronchiolitis so far, even though data concerning its effectiveness have been published.

Methods: A systematic literature review was carried out to determine the role of LUS scores in the diagnosis and prognosis of patients aged 0-2 years with bronchiolitis, using MEDLINE, Scopus and ScienceDirect databases from their inception to December 2021.

Results: A total of 18 studies matching our eligibility criteria were analysed for the purposes of this review and 1249 patients with bronchiolitis were included. The sonographic and radiological findings were comparable and chest radiography was found to have a higher sensitivity in ruling out severe complications such as concomitant pneumonia. The LUS scores were correlated to the clinical course of bronchiolitis and it was able to predict the need of admission in paediatric intensive care unit, the duration of hospitalisation and the need for respiratory support.

Conclusion: This review suggests that LUS could have both a diagnostic and a prognostic role in bronchiolitis during first evaluation in the emergency department and hospitalisation. Physicians could adjust management according to sonographic findings as a useful adjunct to the clinical ones.

Keywords: bronchiolitis; diagnosis; infants; lung ultrasound; prognosis.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Bronchiolitis* / diagnostic imaging
  • Bronchiolitis, Viral* / diagnostic imaging
  • Child, Preschool
  • Humans
  • Infant
  • Infant, Newborn
  • Lung / diagnostic imaging
  • Pneumonia* / diagnosis
  • Prognosis
  • Ultrasonography