Ultrasonographic Air Bronchogram in Pediatric CAP

NCT ID: NCT03556488

Last Updated: 2024-02-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-05-21

Study Completion Date

2024-04-30

Brief Summary

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This study evaluates the prognostic role of the change of arborescent air bronchogram, a typical ultrasonographic finding of lung consolidation due to pneumonia, in the management of pediatric CAP.

Detailed Description

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This is a single-center prospective study to evaluate the prognostic role of the change of arborescent air bronchogram, a typical ultrasonographic finding of lung consolidation due to pneumonia, in the management of CAP in terms of: 1) impact on rate of uncomplicated respiratory infections \[rate of uncomplicated CAP\], 2) relationship to the time of resolution of clinical signs \[time to resolution of fever\], 3) change of antibiotic therapy not guided by microbiological examinations and, 4) length of hospitalization.

At admission, the Pediatric will evaluate clinical signs of respiratory distress, request microbiologic tests (nasopharyngeal swab specimens and pneumococcal urinary antigen) to detect causative pathogens of CAP, and laboratory tests (complete blood cell count, acute-phase reactants C-reactive protein). Finally, all children will undergo chest radiography (CXR). If CXR should be performed before the admission to Pediatric Unit, the radiological exam will be not repeated.

Ultrasonographic evaluation will be performed by Pulmonologists. The first examination will be performed within 12 hours from admission. The Pulmonologists will be blind to clinical and radiological data.

In order to characterize the lung consolidation, a grading system based on the presence and the features of air bronchogram \[static, dynamic, dynamic with areas of lung recruitment\] will be adopted. The operator will collect and store images and videos (10seconds), these findings will be reviewed by an expert Clinician in chest US blind to other data.

After 48h from the admission, all children will undergo follow-up laboratory tests and lung US.

In case of clinical deterioration, children will undergo further ultrasonographic evaluations according pediatric indications.

Finally, all children will undergo lung US after 7 ± 2 days from discharge.

Conditions

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Pneumonia Pediatric Infectious Disorder

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Pediatric CAP

Patients with a clinical diagnosis of CAP and radiographic evidence of lung consolidation, hospitalized in the Pediatric Unit.

US air bronchogram score

Intervention Type DIAGNOSTIC_TEST

On ultrasonographic examination, lung consolidation is defined as a subpleural echo-poor region or one with tissue- like echotexture, depending on the extent of air loss and fluid predominance, which is clearly different from the normal pattern.

The air bronchogram is characterized as: absent, static, dynamic, dynamic with areas of lung recruitment.

Interventions

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US air bronchogram score

On ultrasonographic examination, lung consolidation is defined as a subpleural echo-poor region or one with tissue- like echotexture, depending on the extent of air loss and fluid predominance, which is clearly different from the normal pattern.

The air bronchogram is characterized as: absent, static, dynamic, dynamic with areas of lung recruitment.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Suspected CAP
* Age from 1 to 16 years old
* Admission to Pediatric Unit
* Radiographic evidence of lung consolidation
* Written informed consent from parents

Exclusion Criteria

* Gestational age \< 36 weeks
* Previous diagnosis of cystic fibrosis
* Congenital pulmonary disease.
* Refusal to participate.
Minimum Eligible Age

1 Year

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Catholic University of the Sacred Heart

OTHER

Sponsor Role lead

Responsible Party

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Riccardo Inchingolo

Physician and clinical researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Luca Richeldi, Prof,MD,PhD

Role: STUDY_DIRECTOR

Fondazione Policlinico Universitario A. Gemelli, IRCCS

Riccardo Inchingolo, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Fondazione Policlinico Universitario A. Gemelli, IRCCS

Locations

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Fondazione Policlinico Universitario A. Gemelli

Roma, , Italy

Site Status RECRUITING

Azienda Sanitaria Universitaria Integrata di Trieste - Ospedale di Cattinara

Trieste, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Riccardo Inchingolo, MD, PhD

Role: CONTACT

+390630154236

Facility Contacts

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Riccardo Inchingolo, M.D., Ph.D.

Role: primary

+0630154236

Roberto Copetti, M.D.

Role: primary

References

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Inchingolo R, Copetti R, Smargiassi A, Gerardi RE, Conte EG, Corbo GM, Gatto A, Pierandrei C, Capossela L, Lazzareschi I, Valentini P, Demi L. Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population. J Ultrasound. 2021 Jun;24(2):191-200. doi: 10.1007/s40477-020-00547-7. Epub 2021 Jan 6.

Reference Type DERIVED
PMID: 33409860 (View on PubMed)

Other Identifiers

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13528/18

Identifier Type: -

Identifier Source: org_study_id

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