Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease

Objective: This study aims to identify lung ultrasound (LUS) findings associated with acute chest syndrome (ACS) at the time of admission and 24–48 h later, to compare these to chest radiography (CXR) findings and to establish a score to predict the development of this pulmonary complication in sick...

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Main Authors: Pedro P.M.G. Vieira, Josefina A.P. Braga, Rodrigo Regacini
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Hematology, Transfusion and Cell Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S2531137924003225
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author Pedro P.M.G. Vieira
Josefina A.P. Braga
Rodrigo Regacini
author_facet Pedro P.M.G. Vieira
Josefina A.P. Braga
Rodrigo Regacini
author_sort Pedro P.M.G. Vieira
collection DOAJ
description Objective: This study aims to identify lung ultrasound (LUS) findings associated with acute chest syndrome (ACS) at the time of admission and 24–48 h later, to compare these to chest radiography (CXR) findings and to establish a score to predict the development of this pulmonary complication in sickle cell disease (SCD) children Methods: A prospective observational study of SCD children presenting signs or symptoms of ACS evaluated by LUS and CXR at admission and 24–48 h later. A score was conceived to predict the evolution of ACS during hospitalization based on ultrasonographic findings. Results: Seventy-eight children were evaluated; 61 (78.2 %) developed ACS. A score greater than one at admission showed sensitivity, specificity, accuracy, and positive predictive value (PPV) of 75.4 %, 88.2 %, 78.2 %, and 95.8 %, respectively to predict ACS, while only 32 (52.5 %) CXR showed alterations. The development of ACS during hospitalization was unlikely for a score of zero and very likely for a score greater than one at admission. Regarding follow-up exams, a score greater than one showed sensitivity, specificity, accuracy, and PPV of 98.4 %, 76.5 %, 93.6 %, and 92.8 %, respectively to predict the development of ACS. ACS development was very unlikely for a score of zero and very likely for a score greater than zero in the follow-up. Conclusion: LUS is an effective tool to assess risk for the development of ACS in SCD children with clinical suspicion.
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spelling doaj-art-12e451761fb241d9a6644b00bc4f18cb2024-12-01T05:07:48ZengElsevierHematology, Transfusion and Cell Therapy2531-13792024-11-0146S239S245Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell diseasePedro P.M.G. Vieira0Josefina A.P. Braga1Rodrigo Regacini2Corresponding author at: Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM UNIFESP), Botucatu St. 598, São Paulo, SP, CEP 04023-062, Brazil.; Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM UNIFESP), São Paulo, SP, BrazilEscola Paulista de Medicina da Universidade Federal de São Paulo (EPM UNIFESP), São Paulo, SP, BrazilEscola Paulista de Medicina da Universidade Federal de São Paulo (EPM UNIFESP), São Paulo, SP, BrazilObjective: This study aims to identify lung ultrasound (LUS) findings associated with acute chest syndrome (ACS) at the time of admission and 24–48 h later, to compare these to chest radiography (CXR) findings and to establish a score to predict the development of this pulmonary complication in sickle cell disease (SCD) children Methods: A prospective observational study of SCD children presenting signs or symptoms of ACS evaluated by LUS and CXR at admission and 24–48 h later. A score was conceived to predict the evolution of ACS during hospitalization based on ultrasonographic findings. Results: Seventy-eight children were evaluated; 61 (78.2 %) developed ACS. A score greater than one at admission showed sensitivity, specificity, accuracy, and positive predictive value (PPV) of 75.4 %, 88.2 %, 78.2 %, and 95.8 %, respectively to predict ACS, while only 32 (52.5 %) CXR showed alterations. The development of ACS during hospitalization was unlikely for a score of zero and very likely for a score greater than one at admission. Regarding follow-up exams, a score greater than one showed sensitivity, specificity, accuracy, and PPV of 98.4 %, 76.5 %, 93.6 %, and 92.8 %, respectively to predict the development of ACS. ACS development was very unlikely for a score of zero and very likely for a score greater than zero in the follow-up. Conclusion: LUS is an effective tool to assess risk for the development of ACS in SCD children with clinical suspicion.http://www.sciencedirect.com/science/article/pii/S2531137924003225Sickle cell diseaseAcute chest syndromeLung ultrasoundPoint of care ultrasoundPediatricsChildren
spellingShingle Pedro P.M.G. Vieira
Josefina A.P. Braga
Rodrigo Regacini
Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease
Hematology, Transfusion and Cell Therapy
Sickle cell disease
Acute chest syndrome
Lung ultrasound
Point of care ultrasound
Pediatrics
Children
title Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease
title_full Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease
title_fullStr Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease
title_full_unstemmed Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease
title_short Lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease
title_sort lung ultrasound score to predict development of acute chest syndrome in children with sickle cell disease
topic Sickle cell disease
Acute chest syndrome
Lung ultrasound
Point of care ultrasound
Pediatrics
Children
url http://www.sciencedirect.com/science/article/pii/S2531137924003225
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AT rodrigoregacini lungultrasoundscoretopredictdevelopmentofacutechestsyndromeinchildrenwithsicklecelldisease