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Characterizing Pediatric Lung Ultrasound Findings During a Chemically-induced Bronchospasm
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  • Francois Gagnon,
  • Noah Marzook,
  • Alexandre Deragon,
  • Larry Lands,
  • David Zielinski,
  • Adam Shapiro,
  • Alexander S. Dubrovsky
Francois Gagnon
University of Ottawa Department of Pediatrics
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Noah Marzook
McGill University Faculty of Medicine
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Alexandre Deragon
McGill University Faculty of Medicine
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Larry Lands
McGill University Health Centre
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David Zielinski
McGill University
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Adam Shapiro
Montreal Children's Hospital, McGill University
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Alexander S. Dubrovsky
McGill University Faculty of Medicine
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Abstract

Background: Lung ultrasound (LUS) has been shown to be a useful clinical tool in pediatrics. LUS has been well studied in other respiratory conditions, but very little is known about the LUS findings of asthma. Objectives: The primary objective was to characterize LUS findings of pediatric patients before and after a chemically-induced bronchospasm. The secondary objective was to evaluate the effect of bronchodilators on the LUS findings. Methods: Eligible patients 6 to 17 years old presenting for a methacholine challenge test (MCT) in a pediatric respiratory clinic were recruited. LUS was performed before and after the MCT as well as after bronchodilator administration. LUS were analysed by an expert blinded to the patient characteristics and MCT results. Results: 44 patients were included in the study. 5 patients had positive LUS findings at baseline. 15 patients had a positive LUS following the MCT. There was a significant association between having a chemically-induced bronchospasm and a positive LUS post-MCT (p=0.05, odds ratio 5.3, 95% CI [1.0-27.7]) . Among patients who developed positive LUS findings post-MCT, 4 out of 9 returned to having a negative LUS post-bronchodilator administration. Conclusions: This is the first known report of an association between LUS findings and bronchospasm in pediatric patients. It is also the first documentation of resolution of LUS findings post-bronchodilator administration. Most LUS findings observed were small and limited to one or a few intercostal spaces. Further research is required to evaluate the effect of bronchodilators on LUS in the emergency department.

Peer review status:IN REVISION

04 Jun 2021Submitted to Pediatric Pulmonology
18 Jun 2021Assigned to Editor
18 Jun 2021Submission Checks Completed
02 Jul 2021Reviewer(s) Assigned
25 Jul 2021Review(s) Completed, Editorial Evaluation Pending
11 Aug 2021Editorial Decision: Revise Major