Correlation of clinical and chest radiograph findings in pediatric submersion cases.
Background: Submersion injuries are a leading cause of injury death in children in the United States. The clinical course of a submersion patient varies depending on the presence of anoxic brain injury and acute respiratory failure.Objective: We studied changes in clinical findings and chest radiogr...
| Publicado en: | Pediatric Radiology Vol. 50; no. 4; pp. 492 - 501 |
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| Autores principales: | , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142205015&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142205015 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03010449 O03 jtl: Pediatric Radiology issn: 03010449 maglogo: N pubinfo: dt: Apr2020 vid: 50 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 142205015 142205015 NLM31897567 142205015 10.1007/s00247-019-04588-x NLM31897567 142205015 ppf: 492 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Correlation of clinical and chest radiograph findings in pediatric submersion cases. aug: au: Ho, Brandon J. Crowe, James E. Dorfman, Scott R. Camp, Elizabeth A. Yusuf, Shabana Shenoi, Rohit P. affil: Department of Pediatrics, Children's National Medical Center, Washington, DC, USA sug: subj: Near Drowning Radiography, Thoracic Infant, Newborn Cross Sectional Studies Sensitivity and Specificity Adolescence Child, Preschool Infant Male Female Child Human Infant, Newborn: birth-1 month Adolescent: 13-18 years Child, Preschool: 2-5 years Infant: 1-23 months Child: 6-12 years Male Female ab: Background: Submersion injuries are a leading cause of injury death in children in the United States. The clinical course of a submersion patient varies depending on the presence of anoxic brain injury and acute respiratory failure.Objective: We studied changes in clinical findings and chest radiograph findings and determined the sensitivity/specificity of the presenting chest radiograph in predicting clinical improvement within the first 24 h in pediatric submersion cases.Materials and Methods: We conducted a cross-sectional study of pediatric submersion patients through age 18 years treated at a children's hospital from 2010 to 2013. We reviewed demographics, comorbidities, prehospital/hospital course and chest radiographic findings. Clinical improvement occurred when a child demonstrated normal vital signs and mentation. We compared radiographic findings among children based on clinical improvement up to 24 h post submersion. Using odds ratios, we calculated associations between radiographic findings and clinical improvement. We studied the sensitivity/specificity of the presenting chest radiograph in predicting clinical improvement within 24 h.Results: One hundred forty-two of 262 (54%) patients had initial chest radiographs; 41% had follow-up radiographs. The odds of an abnormal initial chest radiograph were 4 times higher in children with respiratory distress or abnormal mentation at emergency department (ED) presentation compared to children without these findings (odds ratio [OR]=4.83; 95% confidence interval [CI]=2.1-10.85; P<0.001). Improvement in radiographic findings occurred in 85% of children within 24 h. Children with an abnormal initial chest radiograph were 87% less likely to improve clinically by 24 h (P<0.001). A presenting chest radiograph that was normal or with mild pulmonary edema/atelectasis predicted clinical improvement within 24 h (sensitivity 95%, specificity 57%).Conclusion: Most chest radiographic findings improve in pediatric submersion patients who recover within the first 24 h. An initial chest radiograph that is normal or with mild pulmonary edema/atelectasis satisfactorily predicts clinical improvement by 24 h post submersion. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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