Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population

Aims Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization. Methods Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted. Results Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP ( p value 0.027) and a longer defervescence time ( p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization ( p value 0.008). Conclusions USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP. Trial registration number and date of registration NCT03556488, June 14, 2018. Graphic abstract