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Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study

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Abstract

Background

Lung ultrasound (US) in the evaluation of suspected pediatric pneumonia is increasingly used and has a recognized role in evaluating pleural effusions, although there are no detailed studies specifically addressing its use in the pediatric population.

Objectives

To define lung US findings of severe pediatric community-acquired pneumonia that required surgical procedures during admission.

Materials and methods

Our prospective case-control study compared lung US findings in patients ages 1 month to 17 years admitted with community-acquired pneumonia that required surgical procedures from findings those who did not. Lung US was performed at admission and always before surgical procedures. Medical treatment, laboratory and microbiological findings, chest X-ray, computed tomography scan and surgical procedures are described.

Results

One hundred twenty-one children with community-acquired pneumonia were included; of these, 23 underwent surgical intervention. Compared with the control group, children requiring a surgical procedure had a significantly higher rate of large consolidations (52.2%; 95% confidence interval [CI]: 30.6% to 73.2%), larger and complicated pleural effusions (100%; 95% CI: 85.2% to 100%), and both liquid and air bronchograms (73.9%; 95% CI: 51.6% to 89.8%).

Conclusion

Larger consolidations, larger and more complicated pleural effusions, and liquid and air bronchograms were associated with surgical treatment.

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Acknowledgements

We are grateful to Dr. Caterina Bock from Bambino Gesù Children Hospital for her support in reviewing images. We are thankful to the members of the Italian Academy of Thoracic Ultrasound (Accademia Di Ecografia Toracica, ADET) for training and inspiring Italian and international researchers in the field of lung ultrasound.

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Authors and Affiliations

  1. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Danilo Buonsenso, Antonietta Curatola, Rosa Morello & Piero Valentini

  2. Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy

    Danilo Buonsenso

  3. Department of Radiology, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Paolo Tomà

  4. Emergency Department, Ospedale Pediatrico Bambino Gesù, Rome, Italy

    Simona Scateni, Valentina Ferro, Maria Luisa D’Andrea, Nicola Pirozzi & Anna Maria Musolino

  5. Department of Pediatrics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy

    Piero Valentini

Authors
  1. Danilo Buonsenso
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  2. Paolo Tomà
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  3. Simona Scateni
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  4. Antonietta Curatola
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  5. Rosa Morello
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  6. Piero Valentini
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  7. Valentina Ferro
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  8. Maria Luisa D’Andrea
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  9. Nicola Pirozzi
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  10. Anna Maria Musolino
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Correspondence to Danilo Buonsenso.

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Buonsenso, D., Tomà, P., Scateni, S. et al. Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study. Pediatr Radiol 50, 1560–1569 (2020). https://doi.org/10.1007/s00247-020-04750-w

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  • DOI: https://doi.org/10.1007/s00247-020-04750-w

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