Skip to main content
SpringerLink
Log in

Point of care lung ultrasound in preschool children with cystic fibrosis: a case-controlled, prospective, pilot study

  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

Aims

Respiratory complications in Cystic Fibrosis (CF) are still the leading cause of death nowadays in these patients. High-Resolution Computed Tomography is the gold standard method for staging lung disease in CF. In this study we assessed lung ultrasound findings in asymptomatic preschool patients affected by CF.

Methods

This is a case–control study with a total of 70 enrolled patients (20 patients affected by CF, 50 healthy controls) aged from 31 to 6 years. All included patients were without intercurrent lung problems and without antibiotic therapy in the last 30 days. For each patient a lung Point of Care Ultrasound (POCUS) of lung was performed.

Results

B lines < 3 and sub-pleural consolidations < 1 cm were statistically more frequent in CF patients, both in terms of number of affected patients (p 0.02 and p 0.0001 respectively) and frequency (p 0.0181 and p 0.0001 respectively); the prevalence of B lines < 3 in control group was high (47.73%) however the prevalence of sub-pleural consolidations was very low (2.27%). In both groups coalescent B lines affected a greater number of infants and were in higher number of findings than patients aged between 2 and 6 years.

Conclusions

The presence of multiple subpleural pulmonary consolidations < 1 cm in asymptomatic preschool children could be a ultrasound markers of subclinical pulmonary disease such as CF. POCUS of lung is confirmed as a useful tool for the clinician as confirmation of a clinical suspicion, help reduce the use of ionizing radiation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. US CF Foundation, Johns Hopkins University, The hospital for sick children. The clinical and functional translation of CFTR (CFTR2). Available at: https://cftr2.org. Accessed 26 July 2022.

  2. Amaral MD, Hutt DM, Tomati V, Botelho HM, Pedemonte N (2020) CFTR processing, trafficking and interactions. J Cyst Fibros 19(Suppl 1):S33–S36. https://doi.org/10.1016/j.jcf.2019.10.017. (Epub 2019 Oct 31 PMID: 31680043)

    Article  CAS  PubMed  Google Scholar 

  3. Alicandro G, Frova L, Di Fraia G, Colombo C (2015) Cystic fibrosis mortality trend in Italy from 1970 to 2011. J Cyst Fibros 14(2):267–274

    Article  PubMed  Google Scholar 

  4. Bell SC, Mall MA, Gutierrez H et al (2020) The future of cystic fibrosis care: a global perspective. Lancet Respir Med 8:65–124

    Article  CAS  PubMed  Google Scholar 

  5. 2022 Cystic fibrosis foundation patient registry highlights Bethesda, Maryland ©2023 Cystic fibrosis foundation.

  6. Pillarisetti N, Williamson E, Linnane B et al (2011) Australian respiratory early surveillance team for cystic fibrosis (AREST CF). Infection, inflammation, and lung function decline in infants with cystic fibrosis. Am J Respir Crit Care Med 184(1):75–81

    Article  PubMed  Google Scholar 

  7. Rosenow T (2018) Quantifcation of CT bronchiectasis and its relationship to ventilation in cystic fibrosis. Thorax 73(1):4

    Article  PubMed  Google Scholar 

  8. Tiddens HA (2006) Chest computed tomography scans should be considered as a routine investigation in cystic fibrosis. Paediatr Respir Rev 7(3):202–208

    Article  PubMed  Google Scholar 

  9. Pasteur MC, Bilton D, Hill AT (2010) British thoracic society guideline for non-CF bronchiectasis. Thorax 65(Suppl 1):i1-58

    Article  PubMed  Google Scholar 

  10. Tomà P, Owens CM (2013) Chest ultrasound in children: critical appraisal. Pediatr Radiol 43:1427–1434

    Article  PubMed  Google Scholar 

  11. Jaworska J, Komorowska-Piotrowska A, Pomiećko A et al (2020) Consensus on the application of lung ultrasound in pneumonia and bronchiolitis in children. Diagnostics (Basel) 10(11):935

    Article  PubMed  Google Scholar 

  12. Singh Y, Tissot C, Fraga MV et al (2020) International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children issued by the POCUS working group of the European society of paediatric and neonatal intensive care (ESPNIC). Crit Care 24(1):65

    Article  PubMed  PubMed Central  Google Scholar 

  13. Volpicelli G, Elbarbary M, Blaivas M et al (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577–591

    Article  PubMed  Google Scholar 

  14. Amendolea A, Gori L, Adamoli P, Gruppo di studio Pediatrico AdET et al (2021) Pleuropulmonary ultrasound in pediatrics: proposal of a reporting model from the academy of thoracic ultrasound. J Ultrasound Med. https://doi.org/10.1002/jum.15924

    Article  PubMed  Google Scholar 

  15. Soldati G, Smargiassi A, Inchingolo R et al (2020) Proposal for international standardization of the use of lung ultrasound for patients With COVID-19: a simple, quantitative, reproducible method. J Ultrasound Med 39:1413–1419

    Article  PubMed  PubMed Central  Google Scholar 

  16. Buonsenso D, Morello R, Ferro V et al (2022) Are lung ultrasound features more severe in children diagnosed with bronchiolitis after the COVID-19 lockdown period? J Clin Med 11(18):5294

    Article  PubMed  PubMed Central  Google Scholar 

  17. Smargiassi A, Zanforlin A, Perrone T et al (2023) Vertical artifacts as lung ultrasound signs: trick or trap? Part 2- an accademia di ecografia toracica position paper on b-lines and sonographic interstitial syndrome. J Ultrasound Med 42:279–292

    Article  PubMed  Google Scholar 

  18. Musolino AM, Tomà P, De Rose C et al (2022) Ten years of pediatric lung ultrasound: a narrative review. Front Physiol 6(12):721951

    Article  Google Scholar 

  19. Peixoto AO, Marson FA, Dertkigil SS et al (2020) The use of ultrasound as a tool to evaluate pulmonary disease in cystic fibrosis. Respir Care 65(3):293–303

    Article  PubMed  Google Scholar 

  20. Ciuca IM, Pop LL, Dediu M et al (2022) Lung ultrasound in children with cystic fibrosis in comparison with chest computed tomography: a feasibility study. Diagnostics (Basel) 12(2):376

    Article  PubMed  Google Scholar 

  21. Buonsenso D, Soldati G, Curatola A et al (2020) Lung ultrasound pattern in healthy infants during the first 6 months of life. J Ultrasound Med 39(12):2379–2388

    Article  PubMed  Google Scholar 

  22. Strzelczuk-Judka L, Wojsyk-Banaszak I, Zakrzewska A, Jończyk-Potoczna K (2019) Diagnostic value of chest ultrasound in children with cystic fibrosis – pilot study. PLoS ONE 14(7):e0215786

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Raimondi F, Yousef N, Migliaro F, Capasso L, De Luca D (2021) Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications. Pediatr Res 90(3):524–531

    Article  PubMed  Google Scholar 

  24. De Boeck B (2013) A new era in the treatment of cystic fibrosis: correlation of underlying CFTR defect. Lancet resp med. 1(2):158

    Article  Google Scholar 

  25. Linnane BM, Hall GL, Nolan G et al (2008) Lung function in infants with cystic fibrosis diagnosed by newborn screening. Am J Respir Crit Care Med 178(12):1238–1244

    Article  PubMed  Google Scholar 

  26. Hoo AF, Thia LP, Nguyen TT et al (2012) Lung function is abnormal in 3-month-old infants with cystic fibrosis diagnosed by newborn screening. Thorax 67(10):874–881

    Article  PubMed  Google Scholar 

  27. Armstrong DS, Hook SM, Jamsen KM et al (2005) Lower airway inflammation in infants with cystic fibrosis detected by newborn screening. Pediatr Pulmonol 40:500–510

    Article  PubMed  Google Scholar 

  28. Ranganathan SC, Stocks J, Dezateux C et al (2004) The evolution of airway function in early childhood following clinical diagnosis of cystic fibrosis. Am J Respir Crit Care Med 169(8):928–933

    Article  PubMed  Google Scholar 

  29. Sly PD, Gangell CL, Chen L et al (2013) Risk factors for bronchiectasis in children with cystic fibrosis. N Engl J Med 368(21):1963–1970

    Article  CAS  PubMed  Google Scholar 

  30. Mott LS, Park J, Murray CP et al (2012) Progression of early structural lung disease in young children with cystic fibrosis assessed using CT. Thorax 67(6):509–516

    Article  PubMed  Google Scholar 

  31. Stick SM, Brennan S, Murray C et al (2009) Bronchiectasis in infants and preschool children diagnosed with cystic fibrosis after newborn screening. J Pediatr 155(5):623–8.e1

    Article  PubMed  Google Scholar 

  32. Brody AS, Tiddens HAWM, Castile RG et al (2005) Computed tomography in the evaluation of cystic fibrosis lung disease. Am J Respir Crit Care Med 172:1246–1252

    Article  PubMed  Google Scholar 

  33. Hassanzad M, Kiani A, Abedini A et al (2021) Lung ultrasound for the diagnosis of cystic fibrosis pulmonary exacerbation. BMC Pulm Med 21(1):353

    Article  PubMed  PubMed Central  Google Scholar 

  34. Marzook NS, Dubrovsky LC, Lands D, Zielinski AJ, Shapiro (2022) Point of care lung ultrasound in children with cystic fibrosis and primary ciliary dyskinesia.[abstract]. The future’s bright: primary ciliary dyskinesia and cystic fibrosis diagnostic and therapeutic advances. American thoracic society international conference abstracts. May 2022.

Download references

Acknowledgements

We gratefully acknowledge the contribution of the Regional Reference Center for Cystic Fibrosis site at Giovanni Paolo II Hospital of Lamezia Terme (Catanzaro), directed by Dr. Mimma Caloiero, for providing the study data.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165, Rome, Italy

    Antonio Alessandro Crispino & Anna Maria Musolino

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

    Danilo Buonsenso

  3. Centro Di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italia

    Danilo Buonsenso

  4. Unità Operativa Di Pediatria, Presidio Ospedaliero “Giovanni Paolo II” Lamezia Terme, Azienda Sanitaria Provinciale Di Catanzaro, Lamezia Terme, Italy

    Mimma Caloiero

  5. Pediatric Unit, Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, Italy

    Daniela Concolino

Authors
  1. Antonio Alessandro Crispino
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anna Maria Musolino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Danilo Buonsenso
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mimma Caloiero
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daniela Concolino
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Antonio Alessandro Crispino.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

An approval from the competent ethics committee was obtained with protocol N 33/0.0 dated 1–09-2022.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

The authors affirm that human research participants provided informed consent for publication of the images in Figures: 1.A; 1.B; 2.A; 2.B; 2.C; 3.A; 3.B; 4.A; 4.B; 5; 6; 7.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Crispino, A.A., Musolino, A.M., Buonsenso, D. et al. Point of care lung ultrasound in preschool children with cystic fibrosis: a case-controlled, prospective, pilot study. J Ultrasound (2024). https://doi.org/10.1007/s40477-023-00841-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40477-023-00841-0

Keywords

Search

Navigation