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Mongodi S, Cortegiani A, Alonso-Ojembarrena A, Biasucci DG, Bos LDJ, Bouhemad B, Cantinotti M, Ciuca I, Corradi F, Girard M, Gregorio-Hernandez R, Gualano MR, Mojoli F, Ntoumenopoulos G, Pisani L, Raimondi F, Rodriguez-Fanjul J, Savoia M, Smit MR, Tuinman PR, Zieleskiewicz L, De Luca D. ESICM-ESPNIC international expert consensus on quantitative lung ultrasound in intensive care. Intensive Care Med 2025:10.1007/s00134-025-07932-y. [PMID: 40353867 DOI: 10.1007/s00134-025-07932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2025] [Accepted: 04/28/2025] [Indexed: 05/14/2025]
Abstract
PURPOSE To provide an international expert consensus on technical aspects and clinical applications of quantitative lung ultrasound in adult, paediatric and neonatal intensive care. METHODS The European Society of Intensive Care (ESICM) and the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) endorsed the project. We selected an international panel of 20 adult, paediatric and neonatal intensive care experts with clinical and research expertise in quantitative lung ultrasound, plus two non-voting methodologists. Fourteen clinical questions were proposed by the chairs to the panel, who voted for their priority (1-9 Likert-type scale) and proposed modifications/supplementing (two-round vote). All the questions achieved the predefined threshold (mean score > 5) and 14 groups of 3 mixed adult/paediatric experts were identified to develop the statements for each clinical question; predefined groups of experts in the fields of adult and paediatric/neonatal intensive care voted statements specific for these subgroups. An iterative approach was used to obtain the final consensus statements (two-round vote, 1-9 Likert-type scale); statements were classified as with agreement (range 7-9), uncertainty (4-6), disagreement (1-3) when the median score and ≥ 75% of votes laid within a specific range. RESULTS A total of 46 statements were produced (4 adults-only, 4 paediatric/neonatal-only, 38 interdisciplinary); all obtained agreement. This result was also achieved by acknowledging in the statements the current limitations of quantitative lung ultrasound. CONCLUSION This consensus guides the use of quantitative lung ultrasound in adult, paediatric and neonatal intensive care and helps identify the fields where further research will be needed in the future.
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Affiliation(s)
- Silvia Mongodi
- Intensive Care Unit 1, San Matteo Hospital, Pavia, Italy.
| | - Andrea Cortegiani
- Department of Precision Medicine in Medical, Surgical and Critical Care Area (Me.Pre.C.C.), University of Palermo, Palermo, Italy
- Department of Anaesthesia, Intensive Care and Emergency Policlinico Paolo Giaccone, Palermo, Italy
| | - Almudena Alonso-Ojembarrena
- Neonatal Intensive Care Unit, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Research Unit, Biomedical Research and Innovation Institute of Cádiz, Hospital Universitario Puerta del Mar, Cadiz, Spain
| | - Daniele Guerino Biasucci
- Department of Clinical Science and Translational Medicine, Tor Vergata' University of Rome, Rome, Italy
| | - Lieuwe D J Bos
- Intensive Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Belaid Bouhemad
- Department of Anaesthesiology and Intensive Care, C.H.U. Dijon, Dijon, France
- Université Bourgogne Franche‑Comté, LNC UMR866, Dijon, France
| | - Massimo Cantinotti
- Fondazione CNR Regione Toscana G. Monasterio, Ospedale del Cuore, Massa, Italy
| | - Ioana Ciuca
- Pediatric Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
- Pediatric Pulmonology Unit, Clinical County Hospital Timisoara, Timisoara, Romania
| | - Francesco Corradi
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Martin Girard
- Department of Anesthesiology, Centre Hospitalier de L'Université de Montréal, Montréal, Canada
- Imaging and Engineering, Centre de Recherche du Centre Hospitalier de L'Université de Montréal, Montréal, Canada
| | | | - Maria Rosaria Gualano
- UniCamillus - Saint Camillus International University of Health and Medical Sciences, Rome, Italy
- Leadership Research Center, Università Cattolica del Sacro Cuore-Campus Di Roma, Rome, Italy
| | - Francesco Mojoli
- Intensive Care Unit 1, San Matteo Hospital, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università Di Pavia, Pavia, Italy
| | | | - Luigi Pisani
- Department of Precision-Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Anesthesiology and Intensive Care Medicine, University of Bari "Aldo Moro", Bari, Italy
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Francesco Raimondi
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Javier Rodriguez-Fanjul
- Pediatric Intensive Care Unit. Hospital Germans Trias I Pujol, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Marilena Savoia
- Neonatal Intensive Care Unit, S Maria Della Misericordia Hospital, Udine, Italy
| | - Marry R Smit
- Department of Intensive Care, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Pieter R Tuinman
- Department of Intensive Care Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam, the Netherlands
| | - Laurent Zieleskiewicz
- Department of Anesthesia and Critical Care, North Hospital, Marseille APHM, Aix Marseille University, Marseille, France
| | - Daniele De Luca
- Division of Paediatrics and Neonatal Critical Care, APHP-Paris Saclay University, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
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Hernández-García M, Solito C, Pavón Ortiz A, Arguedas Casamayor N, Melé-Casas M, Pons-Tomàs G, F. de Sevilla M, Pino R, Launes C, Guitart C, Girona-Alarcón M, Jordan I, García-García JJ. Characteristics and Risk Factors Associated with SARS-CoV-2 Pneumonias in Hospitalized Pediatric Patients: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1703. [PMID: 37892366 PMCID: PMC10605629 DOI: 10.3390/children10101703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
SARS-CoV-2 pneumonia in children has a lower incidence and severity compared to adults. Risk factors are adolescence and comorbidities. Our aims were to describe the characteristics of children admitted with SARS-CoV-2 pneumonia, identify risk factors associated with severity and compare the cases according to the variant of SARS-CoV-2. This was a descriptive and retrospective study, including patients aged 0-18 years hospitalized in a tertiary-care hospital between 1 March 2020 and 1 March 2022. Epidemiological, clinical, diagnostic and therapeutic data were analyzed. Forty-four patients were admitted; twenty-six (59%) were male and twenty-seven (61%) were older than 12 years. Thirty-six (82%) had comorbidities, the most frequent of which were obesity and asthma. Seven (15.9%) patients required high-flow oxygen, eleven (25%) non-invasive ventilation and four (9.1%) conventional mechanical ventilation. In critically ill patients, higher levels of anemia, lymphopenia, procalcitonin, lactate dehydrogenase (LDH) and hypoalbuminemia and lower levels of HDL-cholesterol were detected (all p < 0.05). Prematurity (p = 0.022) was associated with intensive care unit admission. Patients were younger during the Omicron wave (p < 0.01); no variant was associated with greater severity. In conclusion, pediatric patients with a history of prematurity or with anemia, lymphopenia, elevated procalcitonin, elevated LDH levels, hypoalbuminemia and low HDL-cholesterol levels may require admission and present more severe forms. Apart from age, no notable differences between SARS-CoV-2 variant periods were found.
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Affiliation(s)
- María Hernández-García
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
| | - Claudia Solito
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Alba Pavón Ortiz
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Noelia Arguedas Casamayor
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Maria Melé-Casas
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
| | - Gemma Pons-Tomàs
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
| | - Mariona F. de Sevilla
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rosa Pino
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Cristian Launes
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Carmina Guitart
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain
| | - Mònica Girona-Alarcón
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain
| | - Iolanda Jordan
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain
| | - Juan José García-García
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
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