Measurement of the interbronchial angle in acute viral bronchiolitis

Pediatr Pulmonol. 2024 Feb;59(2):442-448. doi: 10.1002/ppul.26771. Epub 2023 Nov 27.

Abstract

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: 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: 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: The present study demonstrates that there is an association between ITB and AVB severity. The smaller the ITB, the greater the disease severity.

Keywords: interbronchial angle; respiratory syncytial virus; viral bronchiolitis.

MeSH terms

  • Aged, 80 and over
  • Bronchiolitis* / diagnostic imaging
  • Bronchiolitis* / therapy
  • Bronchiolitis, Viral* / diagnostic imaging
  • Bronchiolitis, Viral* / therapy
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Male
  • Pneumonia*
  • Respiratory Syncytial Virus Infections* / diagnostic imaging
  • Respiratory Syncytial Virus Infections* / therapy
  • Respiratory Syncytial Virus, Human*

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