Physiology Assessment by Bedside Ultrasonography in Children
| Status: | Completed |
|---|---|
| Conditions: | Asthma |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 6 - 17 |
| Updated: | 7/11/2015 |
| Start Date: | November 2013 |
| End Date: | June 2015 |
| Contact: | Adam M Isacoff, MD |
| Email: | amisac01@louisville.edu |
| Phone: | 502-629-7212 |
Primary Physiology Assessment by Bedside Ultrasonography in Children
Project Aims: The primary aim is to establish normal ultrasound parameters in healthy
children for internal jugular collapse during respiration. The secondary aim is to explore
potential ultrasound parameters which could be used as surrogate markers for pulmonary
function in the management of children with acute asthma.
Hypothesis: Ultrasound measurements of internal jugular vein collapse of children can be
reliably measured. Children experiencing an asthma exacerbation will have significantly
different measurements than of the same age who are healthy. In addition, ultrasound
measurements of the lung and vasculature will correlate with pulmonary function testing and
asthma clinical scoring.
Intervention: For patients in the normal respiratory physiology (NRP) group, medications
and past medical history will be recorded, along with documentation that the patient has not
had any recent respiratory symptoms or fever. For the acute asthmatics (AA) group, history
of present illness, underlying asthma severity, asthma-related treatment including
admission/discharge from ED, medications, and past medical history will be recorded.
Spirometry readings will be collected on all patients. In addition, a clinical asthma score
will be assigned using the Modified Woods pulmonary index scoring system.
Using bedside ultrasonography with the Sonosite Titan ultrasound machine, each measurement
will be taken with the subject lying in bed with the head of the bed elevated at 45 degrees
with the subject's head in the neutral position. Initially, measurements of the internal
jugular vein at maximal inhalation and exhalation will be recorded, and the difference
between the two will be calculated.
children for internal jugular collapse during respiration. The secondary aim is to explore
potential ultrasound parameters which could be used as surrogate markers for pulmonary
function in the management of children with acute asthma.
Hypothesis: Ultrasound measurements of internal jugular vein collapse of children can be
reliably measured. Children experiencing an asthma exacerbation will have significantly
different measurements than of the same age who are healthy. In addition, ultrasound
measurements of the lung and vasculature will correlate with pulmonary function testing and
asthma clinical scoring.
Intervention: For patients in the normal respiratory physiology (NRP) group, medications
and past medical history will be recorded, along with documentation that the patient has not
had any recent respiratory symptoms or fever. For the acute asthmatics (AA) group, history
of present illness, underlying asthma severity, asthma-related treatment including
admission/discharge from ED, medications, and past medical history will be recorded.
Spirometry readings will be collected on all patients. In addition, a clinical asthma score
will be assigned using the Modified Woods pulmonary index scoring system.
Using bedside ultrasonography with the Sonosite Titan ultrasound machine, each measurement
will be taken with the subject lying in bed with the head of the bed elevated at 45 degrees
with the subject's head in the neutral position. Initially, measurements of the internal
jugular vein at maximal inhalation and exhalation will be recorded, and the difference
between the two will be calculated.
Inclusion Criteria:
Aged 6-17 years old presenting to the emergency department (ED) will be enrolled into the
normal respiratory function group into the age quartiles (6-8 years, 9-11 years, 12-14
years and 15-17 years). The 40 subjects enrolled into the acute exacerbation group will
have a previous physician diagnosis of asthma per parent report and an acute asthma
exacerbation requiring corticosteroids per ED attending physician or fellow.
Exclusion Criteria:
Children in the normal respiratory function group will be excluded from participation if
they have: a baseline chronic lung disorder (including asthma), current respiratory
illness, fever, Emergency Services Index (ESI) triage category of less than or equal to 3
(high acuity), chronic cough, dyspnea with exercise, wheezing, or a history of smoking by
self and/or parent report.
Children in the acute exacerbation group will be excluded from enrollment if they have a
history of baseline chronic lung disease, not including asthma. In addition, a
co-existing acute pulmonary process (e.g. lobar pneumonia), and impending respiratory
failure will exclude from participation. Those who are unable to perform spirometry
measurements per spirometry measuring protocol (see Appendix: Figure 1) will be excluded
from participation.
Subjects will be excluded from either of the groups if they had prior cardiac/pulmonary
disease or surgeries (other than asthma for the acute exacerbation group), significant
musculoskeletal abnormalities (such as scoliosis) that might compromise baseline pulmonary
function testing, a history of smoking tobacco or marijuana, and prematurity (birth at
less than 37 weeks gestation. In addition, those with an allergy to ultrasound gel will
be excluded from participation.
We found this trial at
1
site
Kosair Children's Hospital For more than a century, Kosair Children's Hospital and its predecessor hospitals...
Click here to add this to my saved trials
