Value of lung ultrasound in the assessment of community-acquired pneumonia in infants aged 1-3 months

doi:10.3969/j.issn.1004-583X.2024.03.006

Abstract

Abstract:

Objective To evaluate the clinical value of lung ultrasound score (LUSS) in infants aged 1-3 months who suffered from community-acquired pneumonia (CAP). Methods Clinical data of infants with CAP at the age of 1-3 months and examined by lung ultrasound (LUS) within 48 hours after admission were collected. The severity of pneumonia was quantified and classified, and the correlation of disease severity with LUSS was analyzed. Receiver operating characteristic (ROC) curves were plotted to assess the potential of the LUSS in predicting severe pneumonia. Results The LUSS was significantly higher in infants of severe pneumonia group than those of the mild pneumonia group (12.0[6.0, 21.5] points vs 3.0[1.0, 8.0] points, P<0.05). Disease severity was positively correlated with LUSS (r=0.487, P<0.01). The optimal cut-off value of LUSS in predicting severe pneumonia was 5.5 points, with the sensitivity and specificity of 81.8% and 69.6%, respectively. Conclusion LUSS reflects the severity of CAP in infants aged 1-3 months, and it is a practical tool for clinical evaluation and follow-up monitoring.

Key words: pneumonia, ultrasonography, infant

CLC Number:

R563.1

Zhang Xia, Tang Yan, Liu Wenli, Liu Juan. Value of lung ultrasound in the assessment of community-acquired pneumonia in infants aged 1-3 months[J]. Clinical Focus, 2024, 39(3): 234-238.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.03.006

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I3/234

Figures/Tables 5

References 26

[1]	熊丽君, 陈巧彬, 林萌. 肺部超声评分在儿童社区获得性肺炎的临床应用价值[J]. 福建医药杂志, 2021, 43(1):72-75.
[2]	戚丽雄, 郑跃杰. 儿童肺炎死亡危险因素的研究进展[J]. 国际儿科学杂志, 2020, 47(8):565-568.
[3]	陈敏, 王军, 周雪典, 等. 五岁以下重症肺炎患儿预后的危险因素[J]. 西部医学, 2019, 31(12):1866-1870.
[4]	Ho MC, Ker CR, Hsu JH, et al. Usefulness of lung ultrasound in the diagnosis of community-acquired pneumonia in children[J]. Pediatr Neonatol, 2014, 56(1):40-45.
[5]	中华人民共和国国家健康委员会,国家中医药局. 儿童社区获得性肺炎诊疗规范(2019年版)[J]. 中华临床感染病杂志, 2019, 12(1):6-13.
[6]	Bouhemad B, Zhang M, Lu Q, et al. Clinical review: Bedside lung ultrasound in critical care practice[J]. Crit Care, 2007, 11(1):205.
[7]	Mongodi S, Santangelo E, De Luca D, et al. Quantitative lung ultrasound: Time for a consensus?[J]. Chest, 2020, 158(2):469-470. doi: S0012-3692(20)30859-X pmid: 32768066
[8]	Kessler D, Dessie A, Kanjanauptom P, et al. Lack of association between a quantified lung ultrasound score and illness severity in pediatric emergency department patients with acute lower respiratory infections[J]. J Ultrasound Med, 2022, 41(12):3013-3022.
[9]	宋永玲, 王强, 洪燕, 等. 儿童重症肺炎的临床分析[J]. 武警后勤学院学报(医学版), 2021, 30(5):78-80.
[10]	李茂霞, 万朝敏. 婴幼儿重症肺炎的临床特点及死亡相关因素研究[J]. 中国小儿急救医学, 2015, (2):113-118.
[11]	杨小青, 蒋德林, 张雅林. 377例儿童社区获得性重症肺炎临床特点分析[J]. 中国现代医生, 2022, 60(23):10-13.
[12]	徐雷, 陈蕾, 王冲, 等. 儿童重症肺炎105例临床特征及高危因素分析[J]. 齐鲁医学杂志, 2012, 27(3):250-252.
[13]	陈小军, 白玲娇. 肺部超声评分联合肺潮气功能检测在小儿重症肺炎诊断中的应用价值[J]. 临床医学研究与实践, 2023, 8(16):82-85.
[14]	黑淑贞. 婴儿重症肺炎高危因素分析379例[J]. 中国社区医师, 2016, 32(1):74-75.
[15]	李佑民, 高乃荣, 郑文博, 等. 小婴儿支气管肺炎的临床特点分析[J]. 中国儿童保健杂志, 2008, 16(6):729-730.
[16]	Lovrenski J. Pediatric lung ultrasound-pros and potentials[J]. Pediatr Radiol, 2020, 50(3):306-313. doi: 10.1007/s00247-019-04525-y pmid: 32065266
[17]	姚一明, 曾平, 彭华保, 等. 肺脏超声在儿童社区获得性肺炎中的临床应用价值[J]. 中国临床医生杂志, 2023, 51(5):609-612.
[18]	Omran A, Eesai S, Ibrahim M, et al. Lung ultrasound in diagnosis and follow up of community acquired pneumonia in infants younger than 1-year old[J]. Clin Respir J, 2018, 12(7):2204-2211. doi: 10.1111/crj.12790 pmid: 29570940
[19]	Musolino AM, Tomà P, Supino MC, et al. Lung ultrasound features of children with complicated and noncomplicated community acquired pneumonia: A prospective study[J]. Pediatr Pulmonol, 2019, 54(9):1479-1486.
[20]	Caiulo VA, Gargani L, Caiulo S, et al. Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children[J]. Pediatr Pulmonol, 2013, 48(3):280-287.
[21]	Orso D, Ban A, Guglielmo N. Lung ultrasound in diagnosing pneumonia in childhood: A systematic review and meta-analysis[J]. J Ultrasound, 2018, 21(3):183-195. doi: 10.1007/s40477-018-0306-5 pmid: 29931473
[22]	徐诚之, 刘云, 殷菲. 床旁超声对重症肺炎患者病情严重程度及预后的评估价值[J]. 实用临床医药杂志, 2022, 26(22):38-42.
[23]	Zong HF, Guo G, Liu J, et al. Using lung ultrasound to quantitatively evaluate pulmonary water content[J]. Pediatr Pulmonol, 2020, 55(3):729-739.
[24]	Brat R, Yousef N, Klifa R, et al. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure[J]. JAMA Pediatr, 2015, 169(8):e151797.
[25]	于红奎, 刘晓, 陈嘉坤, 等. 肺超声评分对儿童重症肺炎定量评估及预后判断的价值[J]. 中国超声医学杂志, 2019, 35(3):229-231.
[26]	Supino MC, Buonsenso D, Scateni S, et al. Point-of-care lung ultrasound in infants with bronchiolitis in the pediatric emergency department: A prospective study[J]. Eur J Pediatr, 2019, 178(5):623-632. doi: 10.1007/s00431-019-03335-6 pmid: 30747262

项目	0分	1分	2分	4分
呼吸频率(次/min)	29~61	≥61或≤29	≥81或≤19	≥91或≤15
吸气性凹陷	不使用辅助呼吸肌	轻微胸壁塌陷	中度胸壁塌陷	严重胸壁塌陷和呻吟
氧饱和度	>94%	91~94%	≤90%	-
氧疗情况	无	-	氧流量<4 L/min或FiO₂<50%	氧流量≥4 L/min或FiO₂>50%

项目	0分	1分	2分	4分
呼吸频率(次/min)	29~61	≥61或≤29	≥81或≤19	≥91或≤15
吸气性凹陷	不使用辅助呼吸肌	轻微胸壁塌陷	中度胸壁塌陷	严重胸壁塌陷和呻吟
氧饱和度	>94%	91~94%	≤90%	-
氧疗情况	无	-	氧流量<4 L/min或FiO₂<50%	氧流量≥4 L/min或FiO₂>50%

组别	例数	性别[例(%)]		体重(kg)	日龄(日)	湿啰音[例(%)]
组别	例数	男	女	体重(kg)	日龄(日)	有	无
轻症肺炎组	102	54(52.9)	48(47.1)	4.654±0.707	44.200±11.100	36(35.3)	66(64.7)
重症肺炎组	44	27(61.4)	17(38.6)	4.491±0.863	46.700±14.500	28(63.6)	16(36.4)
统计值		χ²=0.883		t=-1.187	t=1.135	χ²=0.015
P值		0.347		0.237	0.258	0.901

组别	例数	性别[例(%)]		体重(kg)	日龄(日)	湿啰音[例(%)]
组别	例数	男	女	体重(kg)	日龄(日)	有	无
轻症肺炎组	102	54(52.9)	48(47.1)	4.654±0.707	44.200±11.100	36(35.3)	66(64.7)
重症肺炎组	44	27(61.4)	17(38.6)	4.491±0.863	46.700±14.500	28(63.6)	16(36.4)
统计值		χ²=0.883		t=-1.187	t=1.135	χ²=0.015
P值		0.347		0.237	0.258	0.901

组别	例数	LUSS[M(P25,P75)]
轻症肺炎组	102	3.0(1.0, 8.0)
重症肺炎组	44	12.0(6.0, 21.5)
统计值		Z=-6.091
P值		<0.01