Usefulness of Lung Ultrasound in Paediatric Respiratory Diseases

Abstract

Respiratory infection diseases are among the major causes of morbidity and mortality in children. Diagnosis is focused on clinical presentation, yet signs and symptoms are not specific and there is a need for new non-radiating diagnostic tools. Among these, lung ultrasound (LUS) has recently been included in point-of-care protocols showing interesting results. In comparison to other imaging techniques, such as chest X-ray and computed tomography, ultrasonography does not use ionizing radiations. Therefore, it is particularly suitable for clinical follow-up of paediatric patients. LUS requires only 5-10 min and allows physicians to make quick decisions about the patient's management. Nowadays, LUS has become an early diagnostic tool to detect pneumonia during the COVID-19 pandemic. In this narrative review, we show the most recent scientific literature about advantages and limits of LUS performance in children. Furthermore, we discuss the major paediatric indications separately, with a paragraph fully dedicated to COVID-19. Finally, we mention potential future perspectives about LUS application in paediatric respiratory diseases.

Keywords: children; lung ultrasound; respiratory diseases.

Figure 1

Basal lung consolidation in a 8 month-old girl, showing hypoechoic triangular shape, pleural line attenuation (thick arrows), air (thin arrows) and fluid (triangles) bronchograms. Depth is approximately 2.5 cm (dotted green line). Ultrasonographic appearance is compatible with pneumonia. Image captured using a 3.0–16.0 MHz linear array transducer.

Figure 2

Pleural effusion in a 16-year-old boy, showing fine echoes, extending 2 cm (doted green line) from parietal pleura (down-pointing thin arrows) to the diaphragm (up-pointing thin arrows). An atelectatic compressed lung is visible at the bottom of the picture as a triangular hypoechoic formation (white triangle). Image captured using a 1.0–7.0 MHz curved array transducer.