What is it about?

Aim: Lung ultrasound (LUS) has not been included in the current guidelines for the diagnosis of bronchiolitis so far, even though data concerning its effectiveness have been published. Methods: A systematic literature review was carried out to determine the role of LUS scores in the diagnosis and prognosis of patients aged 0–2 years with bronchiolitis, using MEDLINE, Scopus and ScienceDirect databases from their inception to December 2021. Results: A total of 18 studies matching our eligibility criteria were analysed for the purposes of this review and 1249 patients with bronchiolitis were included. The sonographic and radiological findings were comparable and LUS was found to have a higher sensitivity in ruling out severe complications such as concomitant pneumonia. The LUS scores were correlated to the clinical course of bronchiolitis and it was able to predict the need of admission in paediatric intensive care unit, the duration of hospitalisation and the need for respiratory support. Conclusion: This review suggests that LUS could have both a diagnostic and a prognostic role in bronchiolitis during first evaluation in the emergency department and hospitalisation. Physicians could adjust management according to sonographic findings as a useful adjunct to the clinical ones.

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Why is it important?

Our systematic review shows the significant assisting role of lung ultrasonography in primary assessment and follow-up of infants with bronchiolitis. Lund ultrasound scores were found to correlate with the clinical scores, the need for admission to intensive care unit, the need and the duration for hospitalisation and the need and the duration or respiratory support. Radiological and sonographic findings were also found to correlate in ruling out several complications. This is the first time prognostic and diagnostic role of lung ultrasound is been assessed.


Writing this article was a great pleasure as it has co-authors with whom I have had a creative collaboration. This article also leads to a wide discussion between paediatric pulmonologists and radiologists towards a better understanding of the role of lung ultrasonography as a point-of-care tool.

Christos Kogias
National and Kapodistrian University of Athens

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This page is a summary of: Lung ultrasound systematic review shows its prognostic and diagnostic role in acute viral bronchiolitis, Acta Paediatrica, October 2022, Wiley,
DOI: 10.1111/apa.16578.
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