Objective and design: Our prospective observational study is the first
study that evaluates the LUS findings of cardiopulmonary interactions in
acutely ill children with elevated pro-BNP levels,with the aim of
establishing the specific LUS pattern in this category of patients
without primary lung diseases.Methodology:We prospectively analyzed
epidemiological, clinical, laboratory, instrumental and lung ultrasound
parameters in acutely ill children aged 1 month to 18 years admitted to
the Department of Pediatrics between March 2020 to August 2020.Among the
acutely ill patients evaluated, only patients with pro-BNP>
300 pg / ml and who underwent LUS before the start of any treatment were
included. They were stratified into three sub-categories based on the
diagnosis A) cardiac disease, B) systemic inflammatory disease / sepsis
without functional and / or organic alterations of the myocardium and C)
systemic inflammatory disease / sepsis and cardiac disease, and were
classified into two groups based on the level of pro-BNP.We also
enrolled patients belonging to two other categories (patients with
primary infectious lung disease and completely healthy patients)
analyzing their epidemiological, clinical, laboratory, instrumental
parameters and lung ultrasound findings and comparing them with those of
acutely ill children.Results and Conclusion: We found that LUS findings
in these acutely ill children are different from the ultrasound pattern
of other categories of children and in particular 1) children with acute
lower respiratory tract infections and 2) healthy infants.The finding in
a child of a sonographic interstitial syndrome with multiple, bright,
long, separate and non-confluent B-lines / long vertical artefacts
deriving from a normal and regular pleural line, in the absence of
subpleural consolidations, is strongly predictive of cardiogenic
pulmonary edema or pulmonary congestion in the course of systemic
inflammatory disease / sepsis.
Lung Ultrasound to detect cardiopulmonary interactions in acutely ill children