Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population

Inchingolo, Riccardo; Copetti, Roberto; Smargiassi, Andrea; Gerardi, Rafael Emanuele; Conte, Emanuele Giovanni; Corbo, Giuseppe Maria; Gatto, Antonio; Pierandrei, Chiara; Capossela, Lavinia; Lazzareschi, Ilaria; Valentini, Piero; Demi, Libertario

AIMS: Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization. METHODS: Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted. RESULTS: Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008). CONCLUSIONS: USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: NCT03556488, June 14, 2018. GRAPHIC ABSTRACT: [Image: see text] ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40477-020-00547-7) contains supplementary material, which is available to authorized users.