Role of lung ultrasound and neutrophil-lymphocyte ratio in prognosticating bronchiolitis in a resource-limited centre

Introduction: Bronchiolitis is a clinical syndrome of respiratory distress that occurs in children under 2 years of age, characterized by upper respiratory symptoms with lower respiratory tract infection and inflammation and no other explanation for the wheezing. Lung Ultrasound Score (LUS) is a safe, non-invasive imaging test that could benefit the management of bronchiolitis.
Objectives: To examine LUS and neutrophil lymphocyte ratio (NLR) to predict the severity in children with bronchiolitis.
Method: A total of 50 cases of acute bronchiolitis was enrolled in the study. Cases were divided into non-severe and severe bronchiolitis based on the clinical score. The association of NLR and LUS with severity was studied. The statistical analysis of the study was done using SPSS version 23.0.
Results: A mean NLR of 0.64 was considered significant based on a previous study by Gul A, et al. According to the clinical scoring of bronchiolitis, out of 50 cases of acute bronchiolitis, 36 were severe, and 14 were non-severe. Among the patients with an NLR greater than 0.64, 8 (16%) were non-severe, and 20 (40%) were severe clinically. Based on the LUS scores, patients were classified as non-severe bronchiolitis with scores ≤3 (80%) and severe bronchiolitis >3 (20%). All patients with severe LUS findings were classified as severe bronchiolitis based on the clinical scores.
Conclusions: Lung ultrasound score can be considered a safe and sensitive investigative modality in bronchiolitis.