Utilidad de la ecografía pulmonar precoz en bronquiolitis aguda leve-moderadaEstudio piloto

Abstract

Objective To determine the correlation between the findings seen in early lung ultrasound with the clinical severity scales, and its association with the subsequent progression of the mild-moderate acute bronchiolitis (AB). Patients and methods An observational prospective study conducted on infants with mild-moderate BA, using lung ultrasound in the first 24hours of hospital care. The lung involvement was graded (range 0-50 points) based on an ultrasound score (ScECO) and 2routinely used clinical scales: the modified Wood Downes Ferres (WDFM), and the Hospital Sant Joan de Deu (HSJD). The relationship between the ScECO and the subsequent clinical progression (admission to the Paediatric Intensive Care Unit (PICU), days in hospital, and days of oxygen therapy), was also determined. Results The study included a total of 59 patients, with a median age of 90 days (IQR: 30-270 days). The median ScECO score was 6 points (2-8) in the patients that did not require hospital admission, with 9 points (5-13.7) admitted to the ward, and 17 (14.5-18) in the patients who needed to be transferred from the ward to the PICU (P=.001). The ScECO had a moderate lineal association with the WDFM scale (rho=0.504, P<.001) and the HSJD (rho=0.518; P<.001). The ScECO was associated with admission to PICU [OR 2.5 (95% CI: 1.1-5.9); P=.035], longer hospital stay [1.2 days 95% CI: 0.55-1.86); P=.001] and duration of oxygen therapy [0.87 days (95% CI: 0.26-1.48); P=.006]. Conclusions There is a moderate correlation between early lung ultrasound findings with the severity of the AB evaluated by the clinical scales, as well as some relationship with the clinical progression.