Alteraciones radiograficas en niños con asma agudizado

Roman, A.; Romero, P.; Fernandez, E.; Bandres, R.M.; Del Campo, J.L.; Rego, G.F.

doi:10.1016/S0300-2896(15)32194-3

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Oviedo" "etiqueta" => "*" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Radiographic alterations in children with acute asthma" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1984-06-26" "fechaAceptado" => "1984-11-24" "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "Para determinar el valor de la radiografía de tórax convencional en niños con asma agudizado, evaluamos las de 73 niños, de 7 a 15 años.Cuarenta y seis pacientes (63%) (grupo I) no tenían alteraciones; 19 (26%) (grupo II) presentaban radiografía «positiva no complicada» (hiperinsuflación, incremento de marcas vasculares centrales, engrosamiento peribronquial, atelectasia subsegmentaria única) y 8 (10,9 %) (grupo III) radiografía «positiva complicada» (atelectasias segmentarias e infiltrados); no hubo ningún caso de neumotórax ni de neumomediastino).Los del grupo III tenían más leucocitos que los del II (p < 0,05) y que los del I (p < 0,05). Los del III presentaban crisis más prolongadas que los del II (p < 0,05) y que los del I (p < 0,001). No había diferencias en los parámetros de la agudización.No se recomienda la realización de la radiografía de tórax de forma rutinaria dada la escasa prevalencia de la forma «positiva complicada» y su falta de influencia en la recuperación de la agudización. La leucocitosis y la larga duración de la crisis son parámetros útiles para la indicación de la exploración radiográfica." ] "en" => array:1 [ "resumen" => "In an attempt to evaluate the usefulness of conventional chest radiography in children with acute asthma we studied 73 children aged from 7 to 15 years.Forty-six of the children from group I (63%) did not show any alterations; nineteen from group II (26%) had positive, non-complicated images (hyperinflation, increased central lung marking, peribronchial enlargement and atelectasis involving the lower segments only) while eight children from group III (10.9%) had positive, complicated images (segmental atelectasis and infiltrates); there were no cases with pneumothorax or pneumomediastinum.Leucocyte counts were higher in group III than in group II (p < 0.05) or group I (p < 0.05). The acute attack lasted longer in group III than in group II (p < 0.05) and group I (p < 0.001). There were no differences in the parameters of acuteness.Routine chest x-rays are not considered advisable because positive complicated images are infrequent and do not exert any influence on recovery from acute attacks.A high leucocyte count and persistence of the acuteness are indications that a chest x-ray may be required." ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "X-rays in chilhood asthma" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Anónimo" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-8587(14)70173-1" "Revista" => array:5 [ "tituloSerie" => "Lancet" "fecha" => "1983" "volumen" => "2" "paginaInicial" => "894" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25217178" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The usefulness of chest radiographs in first asthma attacks" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.C. Gershel" 1 => "H.S. Goldman" 2 => "R.E.K. Stein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM198308113090603" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1983" "volumen" => "309" "paginaInicial" => "336" "paginaFinal" => "339" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6866069" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chest X-rays and childhood asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.R.N. Gillies" 1 => "S.P. Conway" 2 => "J.M. 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Bierman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "1974" "volumen" => "54" "paginaInicial" => "442" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4415453" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Emergency room radiography of asthma. An efficacy study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.E. Zieverink" 1 => "A.P. Harper" 2 => "R.W. Holden" 3 => "E.C. Klatte" 4 => "H. 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Influencia de la edad y años de evolución de la enfermedad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.T. Alvarez" 1 => "B. Del Busto" 2 => "L.F. Diez" 3 => "J.L. M. del Campo" 4 => "A. Román" 5 => "G. F. Rego" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1983" "volumen" => "19" "paginaInicial" => "113" "paginaFinal" => "116" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of severe asthma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W. Franklin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM197406272902606" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1974" "volumen" => "290" "paginaInicial" => "1469" "paginaFinal" => "1472" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4151609" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I.H. Kerr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Asthma" "paginaInicial" => "105" "paginaFinal" => "125" "serieFecha" => "1977" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14." 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Archivos de Bronconeumología

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Vol. 21. Issue 2.

Pages 58-62 (March - April 1985)

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Pages 58-62 (March - April 1985)

DOI: 10.1016/S0300-2896(15)32194-3

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Alteraciones radiograficas en niños con asma agudizado

Radiographic alterations in children with acute asthma

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A. Roman, P. Romero, E. Fernandez, R.M. Bandres, J.L. Del Campo, G.F. Rego

Servicio de Neumología. Instituto Nacional de Silicosis. Oviedo

A. Diaz*

* Servicio de Radiología. Instituto Nacional de Silicosis. Oviedo

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Para determinar el valor de la radiografía de tórax convencional en niños con asma agudizado, evaluamos las de 73 niños, de 7 a 15 años.

Cuarenta y seis pacientes (63%) (grupo I) no tenían alteraciones; 19 (26%) (grupo II) presentaban radiografía «positiva no complicada» (hiperinsuflación, incremento de marcas vasculares centrales, engrosamiento peribronquial, atelectasia subsegmentaria única) y 8 (10,9 %) (grupo III) radiografía «positiva complicada» (atelectasias segmentarias e infiltrados); no hubo ningún caso de neumotórax ni de neumomediastino).

Los del grupo III tenían más leucocitos que los del II (p < 0,05) y que los del I (p < 0,05). Los del III presentaban crisis más prolongadas que los del II (p < 0,05) y que los del I (p < 0,001). No había diferencias en los parámetros de la agudización.

No se recomienda la realización de la radiografía de tórax de forma rutinaria dada la escasa prevalencia de la forma «positiva complicada» y su falta de influencia en la recuperación de la agudización. La leucocitosis y la larga duración de la crisis son parámetros útiles para la indicación de la exploración radiográfica.

In an attempt to evaluate the usefulness of conventional chest radiography in children with acute asthma we studied 73 children aged from 7 to 15 years.

Forty-six of the children from group I (63%) did not show any alterations; nineteen from group II (26%) had positive, non-complicated images (hyperinflation, increased central lung marking, peribronchial enlargement and atelectasis involving the lower segments only) while eight children from group III (10.9%) had positive, complicated images (segmental atelectasis and infiltrates); there were no cases with pneumothorax or pneumomediastinum.

Leucocyte counts were higher in group III than in group II (p < 0.05) or group I (p < 0.05). The acute attack lasted longer in group III than in group II (p < 0.05) and group I (p < 0.001). There were no differences in the parameters of acuteness.

Routine chest x-rays are not considered advisable because positive complicated images are infrequent and do not exert any influence on recovery from acute attacks.

A high leucocyte count and persistence of the acuteness are indications that a chest x-ray may be required.

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