Bedside Lung Ultrasound in Young Children Presenting to the Emergency Department (ED) With Wheezing
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Purpose
Young children presenting to the Emergency Department (ED) with wheezing often have prolonged stays in the ED or even get admitted to the hospital. This is a prospective observational study in which the investigators will use bedside 2D ultrasound to evaluate the lung ultrasound findings in children less than 24 months presenting to the ED with wheezing.
The investigators hypothesize that children less than 24 months presenting to the Emergency Department with wheezing will have a range of lung ultrasound findings that will include normal findings, B lines, subpleural consolidations, and pleural effusions. The investigators also hypothesize that the findings will be reproducible between two equally trained providers.
The investigators also hypothesize that lung ultrasound findings patients 0-24 months presenting to the ED with wheezing will correlate with specific clinical outcomes. An exploratory analysis will be performed to look for correlations between lung US findings and acute severity, final diagnosis, presenting symptoms, prematurity, risk factors for atopy, response to treatment and radiologic or viral studies if performed.
| Condition |
|---|
|
Wheezing Bronchiolitis |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Prospective Observational Study Evaluating the Use of Bedside Lung Ultrasound in Young Children Presenting to the Emergency Department With Wheezing |
| Estimated Enrollment: | 30 |
| Study Start Date: | October 2012 |
Specific Aim 1: To qualify lung US findings in a convenience sample of young children presenting to the ED with bronchiolitis with review by a second provider to determine the reproducibility of the findings.
reproducibility of the findings.
Hypothesis 1a: Children less than 24 months presenting to the Emergency Department with wheezing will have a range of lung ultrasound findings that will include normal findings, B lines, subpleural consolidations, and pleural effusions.
Hypothesis 1b: Findings will be reproducible between two equally trained providers.
Specific Aim 2: The frequency of B lines, subpleural consolidations, and pleural effusions on lung US in a convenience sample of patients 0-24 months presenting the ED with wheezing will be quantified using continuous variable means and standard deviations. An exploratory analysis will be performed to look for correlations between lung US findings and clinical outcomes including discharge from the ED or admission to the hospital, including the intensive care unit, and length of stay in the ED. A further exploratory analysis will be done to look for correlations between lung ultrasound findings and acute severity, final diagnosis, presenting symptoms, prematurity and risk factors for atopy.
Hypothesis 2a: The presence of B lines, subpleural consolidations, and pleural effusions on lung US in a convenience sample of patients 0-24 months presenting the ED with wheezing will correlate with specific clinical outcomes.
Hypothesis 2b: The presence of B lines, subpleural consolidations, and pleural effusions on lung US in a convenience sample of patients 0-24 months presenting the ED with wheezing will positively correlate with a history of prematurity and negatively correlate with a history consistent with atopy.
Eligibility| Ages Eligible for Study: | up to 24 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Children 0-24 months presenting to a pediatric Emergency Department with wheezing
Inclusion Criteria:
- Age less than or equal to 24 months
- Presenting to the pediatric ED with wheezing
Exclusion Criteria:
- On home oxygen at baseline
- Cyanotic congenital cardiac disease (including: ToF, TAPVR, HLHS, d-TGA, TA, pulm atresia, critical pulm stenosis, but not including VSD, ASD, Coarctation of the Aorta)
- Endotracheal tube or tracheostomy in place and/or receiving mechanical ventilation
- Transferred from an outside hospital
Contacts and Locations| United States, District of Columbia | |
| Children's National Medical Center Division of Emergency Medicine | Recruiting |
| Washington, District of Columbia, United States, 10010 | |
| Contact: Joanna S Cohen, MD 202-476-4177 jcohen@cnmc.org | |
| Principal Investigator: Joanna S Cohen, MD | |
| Principal Investigator: | Joanna S Cohen, MD | Childrens National Medical Center |
More Information
Publications:
| Responsible Party: | Joanna Cohen, Assistant Professor of Pediatrics and Emergency Medicine, Children's Research Institute |
| ClinicalTrials.gov Identifier: | NCT01452945 History of Changes |
| Other Study ID Numbers: | Pro00002000 |
| Study First Received: | October 13, 2011 |
| Last Updated: | October 19, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Bronchiolitis Emergencies Respiratory Sounds Bronchitis Bronchial Diseases Respiratory Tract Diseases Lung Diseases, Obstructive |
Lung Diseases Respiratory Tract Infections Disease Attributes Pathologic Processes Signs and Symptoms, Respiratory Signs and Symptoms |
ClinicalTrials.gov processed this record on June 17, 2013