Role of early lung ultrasound in predicting disease progression of acute bronchiolitis

Background: Although clinical assessment is typically diagnostic for bronchiolitis in children, recent literature suggests that early lung ultrasound (LUS) can predict disease progression and help identify children at risk of developing severe illness. This is due to its non-invasive nature, safety, and ability to provide real-time, rapid findings. Purpose: The aim of the study was to determine the correlation between early LUS findings and clinical severity scores. Additionally, the study sought to evaluate the role of early LUS in predicting disease progression and the severity of bronchiolitis, specifically in relation to the need for oxygen supplementation, the duration of oxygen therapy, the length of hospitalization, and intensive care unit (ICU) stay. Methods: This was a single-centre prospective observational study conducted at a tertiary hospital in South India. Infants with mild-to-moderate bronchiolitis, as determined by clinical severity scores, underwent early LUS within the first 24 hours of their presentation to the hospital. They were categorized into mild, moderate, and severe groups based on bronchiolitis-specific early LUS findings. Daily clinical scores were recorded, and the highest clinical score was used to assess disease progression correlation. Results: A total of 127 children, with a mean age of 5.02 ± 3 months, were recruited for the study. According to the modified TAL clinical bronchiolitis severity score, 71 children were classified as having mild bronchiolitis, while 56 had moderate bronchiolitis. The final analysis revealed that the early LUS score had a strong correlation with disease progression (rho = 0.869, P < 0.001). Additionally, the early LUS score significantly correlated with the need for supplemental oxygen (rho = 0.889, P < 0.001), length of hospital stay (rho = 0.851, P < 0.001), and ICU stay (rho = 0.904, P < 0.001). Conclusion: Early LUS demonstrated a strong correlation with disease progression, as indicated by highest clinical scores in mild-to-moderate bronchiolitis