Characterizing Pediatric Lung Ultrasound Findings During a
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.