Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study
We aimed to delineate cardiopulmonary interactions in acute bronchiolitis and to evaluate the capacity of a combined cardiopulmonary ultrasonography to predict the need for respiratory support. This was a prospective observational single-center study that includes infants <12 month of age admitte...
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| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/8/1/12 |
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| author | Moises Rodriguez-Gonzalez Patricia Rodriguez-Campoy Ana Estalella-Mendoza Ana Castellano-Martinez Jose Carlos Flores-Gonzalez |
| author_facet | Moises Rodriguez-Gonzalez Patricia Rodriguez-Campoy Ana Estalella-Mendoza Ana Castellano-Martinez Jose Carlos Flores-Gonzalez |
| author_sort | Moises Rodriguez-Gonzalez |
| collection | DOAJ |
| description | We aimed to delineate cardiopulmonary interactions in acute bronchiolitis and to evaluate the capacity of a combined cardiopulmonary ultrasonography to predict the need for respiratory support. This was a prospective observational single-center study that includes infants <12 month of age admitted to a hospital due to acute bronchiolitis. All the included patients underwent clinical, laboratory and cardiopulmonary ultrasonographic evaluation at the same time point within 24 h of hospital admission. The existence of significant correlation between cardiac and respiratory parameters was the primary outcome. The association of different cardiopulmonary variables with the need of respiratory support higher than O<sub>2</sub>, the length of stay hospitalization, the PICU stay and the duration of respiratory support were a secondary outcome. We enrolled 112 infants (median age 1 (0.5–3) months; 62% males) hospitalized with acute bronchiolitis. Increased values of the pulmonary variables (BROSJOD score, pCO<sub>2</sub> and LUS) showed moderate correlations with NT-proBNP and all echocardiographic parameters indicative of pulmonary hypertension and myocardial dysfunction (Tei index). Up to 36 (32%) infants required respiratory support during the hospitalization. This group presented with higher lung ultrasound score (<i>p</i> < 0.001) and increased values of NT-proBNP (<i>p</i> < 0.001), the Tei index (<i>p</i> < 0.001) and pulmonary artery pressures (<i>p</i> < 0.001). All the analyzed respiratory and cardiac variables showed moderate-to-strong correlations with the LOS of hospitalization and the time of respiratory support. Lung ultrasound and echocardiography showed a moderate-to-strong predictive accuracy for the need of respiratory support in the ROC analysis, with the AUC varying from 0.74 to 0.87. Those cases of bronchiolitis with a worse pulmonary status presented with a more impaired cardiac status. Cardiopulmonary ultrasonography could be a useful tool to easily identify high-risk populations for complicated acute bronchiolitis hospitalization. |
| first_indexed | 2024-03-09T20:56:56Z |
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| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-09T20:56:56Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-ec67e05c36634d46b8fce3e3bf663e0a2023-11-23T22:19:23ZengMDPI AGTomography2379-13812379-139X2022-01-018114215710.3390/tomography8010012Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound StudyMoises Rodriguez-Gonzalez0Patricia Rodriguez-Campoy1Ana Estalella-Mendoza2Ana Castellano-Martinez3Jose Carlos Flores-Gonzalez4Pediatric Cardiology Division, Puerta del Mar University Hospital, 11010 Cadiz, SpainPediatric Intensive Care Unit, Puerta del Mar University Hospital, 11010 Cadiz, SpainPediatric Intensive Care Unit, Puerta del Mar University Hospital, 11010 Cadiz, SpainPediatric Nephrology Division, Puerta del Mar University Hospital, 11010 Cadiz, SpainPediatric Intensive Care Unit, Puerta del Mar University Hospital, 11010 Cadiz, SpainWe aimed to delineate cardiopulmonary interactions in acute bronchiolitis and to evaluate the capacity of a combined cardiopulmonary ultrasonography to predict the need for respiratory support. This was a prospective observational single-center study that includes infants <12 month of age admitted to a hospital due to acute bronchiolitis. All the included patients underwent clinical, laboratory and cardiopulmonary ultrasonographic evaluation at the same time point within 24 h of hospital admission. The existence of significant correlation between cardiac and respiratory parameters was the primary outcome. The association of different cardiopulmonary variables with the need of respiratory support higher than O<sub>2</sub>, the length of stay hospitalization, the PICU stay and the duration of respiratory support were a secondary outcome. We enrolled 112 infants (median age 1 (0.5–3) months; 62% males) hospitalized with acute bronchiolitis. Increased values of the pulmonary variables (BROSJOD score, pCO<sub>2</sub> and LUS) showed moderate correlations with NT-proBNP and all echocardiographic parameters indicative of pulmonary hypertension and myocardial dysfunction (Tei index). Up to 36 (32%) infants required respiratory support during the hospitalization. This group presented with higher lung ultrasound score (<i>p</i> < 0.001) and increased values of NT-proBNP (<i>p</i> < 0.001), the Tei index (<i>p</i> < 0.001) and pulmonary artery pressures (<i>p</i> < 0.001). All the analyzed respiratory and cardiac variables showed moderate-to-strong correlations with the LOS of hospitalization and the time of respiratory support. Lung ultrasound and echocardiography showed a moderate-to-strong predictive accuracy for the need of respiratory support in the ROC analysis, with the AUC varying from 0.74 to 0.87. Those cases of bronchiolitis with a worse pulmonary status presented with a more impaired cardiac status. Cardiopulmonary ultrasonography could be a useful tool to easily identify high-risk populations for complicated acute bronchiolitis hospitalization.https://www.mdpi.com/2379-139X/8/1/12acute bronchiolitislung ultrasoundechocardiographypoint of care ultrasonographycardiopulmonary ultrasoundcardiopulmonary interactions |
| spellingShingle | Moises Rodriguez-Gonzalez Patricia Rodriguez-Campoy Ana Estalella-Mendoza Ana Castellano-Martinez Jose Carlos Flores-Gonzalez Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study Tomography acute bronchiolitis lung ultrasound echocardiography point of care ultrasonography cardiopulmonary ultrasound cardiopulmonary interactions |
| title | Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study |
| title_full | Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study |
| title_fullStr | Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study |
| title_full_unstemmed | Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study |
| title_short | Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study |
| title_sort | characterization of cardiopulmonary interactions and exploring their prognostic value in acute bronchiolitis a prospective cardiopulmonary ultrasound study |
| topic | acute bronchiolitis lung ultrasound echocardiography point of care ultrasonography cardiopulmonary ultrasound cardiopulmonary interactions |
| url | https://www.mdpi.com/2379-139X/8/1/12 |
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