Hermes

ed by: Akshay Kumar Saxena E-mail: fatakshay@yahoo.com Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 6.0 s, respectively. The authors concluded that POCUS is a rapid and reliable method for identifying endotracheal tube placement in the neonatal population. Pediatric empyema: are ultrasound characteristics at the time of intervention predictive of reintervention? Haggie S, Selvadurai H, Gunasekera H et al Pediatr Pulmonol (2022) 57:1643-1650 Empyema and parapneumonic effusions are common complications of community-acquired pneumonia in children. Invasive treatment options include chest drainage with fibrinolytic therapy or video‐assisted thoracoscopic surgery (VATS). US findings are important in guiding appropriate intervention in the treatment of empyema in children. In this retrospective study of 129 children with complicated pneumonia, the authors evaluated whether US characteristics of the pleural fluid at the time of chest drainage with fibrinolytic therapy can predict the future need for reintervention. Two senior consultant pediatric interventional radiologists evaluated the sonographic features: echogenicity of the fluid, septations, loculations, visceral pleural thickness and depth of fluid. The radiologists also subjectively predicted whether each child was at high risk for reintervention, defined as any follow-up invasive procedure after the primary chest drainage. Interobserver reliability was moderate for number of septations; weak for size of largest locule; and minimal for fluid echogenicity, pleural thickening, depth of effusion and radiologist’s subjective prediction for risk of reintervention. The authors concluded that among the children in their large cohort managed with chest drainage and fibrinolytic therapy, the US characteristics that they evaluated were not predictive of the eventual need for reintervention. Cranial ultrasound and MRI: complementary or not in the diagnostic assessment of children with congenital CMV infection? Keymeulen A, De Leenheer E, Casaer A et al Eur J Pediatr (2022) 181:911-920 338 Pediatric Radiology (2023) 53:337–338

LCI or with bacterial colonization. Children with abnormal glucose tolerance had statistically significant higher stiffness levels compared to those with normal glucose tolerance. The authors concluded that liver stiffness measurement by 2-D shear wave elastography is a feasible examination and reliable addition to the liver disease screening in children with cystic fibrosis, which is associated with lower vitamin D levels, decreased lung function and abnormal glucose tolerance.
Diagnostic accuracy of point-of-care ultrasound compared to standard-of-care methods for endotracheal tube placement in neonates Ariff S, Ali KQ, Tessaro MO et al Pediatr Pulmonol (2022)

57:1744-1750
Endotracheal tube placement is a commonly performed life-saving procedure in the neonatal intensive care unit (NICU) and in delivery and operating rooms. Esophageal intubation is the most frequent adverse event associated with this procedure. In this observational diagnostic accuracy study, 20 health care providers certified in its use employed point-of-care ultrasound (POCUS) to confirm appropriate endotracheal tube placement in the trachea. Standard-of-care methods including auscultation, colorimetric capnography and chest radiographs were performed simultaneously. The time for each of these methods was recorded by independent study staff. The intubations took place in neonates in the NICU as well as the delivery and operating rooms. The study enrolled 348 neonates, 58% of whom were intubated emergently; these intubations included 318 tracheal intubations and 30 esophageal intubations, confirmed by at least two standard methods (auscultation, capnography and chest radiography). Comparison of POCUS against standard-ofcare methods for endotracheal tube location revealed 99.7% sensitivity, 91% specificity and 98.9% agreement (kappa: 0.93; P<0.0001). Comparison of POCUS results against an independent POCUS expert for endotracheal tube location revealed 100% sensitivity, 94% specificity and 99.4% agreement (kappa: 0.96; P<0.0001). The median time required for POCUS, capnography and auscultation was 3.0 s, 3.0 s and Congenital cytomegalovirus (CMV) is globally the commonest congenital infection and has the potential for direct brain injury and disruption of normal brain development. A wide spectrum of brain abnormalities and varied clinical manifestations can be encountered in congenital CMV infection. While both cranial US and brain MRI are performed in cases of congenital CMV infection, the exact role of MRI remains a topic of debate. The authors evaluated the diagnostic value of the combination of both cranial US and brain MRI compared to the use of US alone for the detection of central nervous system (CNS) lesions and determining the need for therapy. The study population consisted of 639 infants recorded in a registry in Flanders, Belgium, who had had both US and MRI performed postnatally. The infants were classified according to Flemish consensus as either asymptomatic, or mildly, moderately or severely symptomatic. The cranial US was interpreted as normal in 480/639 children. Of these 480 children, 93 (19%) had abnormal MRI findings, 85/93 (91%) were classified as symptomatic and 47 as severely symptomatic. Conversely, 56 children had lesions detected on US that were not detected on MRI. Lenticulostriate vasculopathy was seen on US in 70 infants, and on none of the MRI studies. The sensitivity, specificity, positive predictive value and negative predictive value of US for assessing complete CNS involvement were 52.5%, 75.4%, 64.8% and 80.5%, respectively. In the study population, therapy was given to 179/639 (28%) of the neonates, including 47 infants (26.2%) in whom the MRI lesions were the only indication for treatment. The authors concluded that MRI has an enhanced role in evaluating infants with congenital CMV infection but that US and MRI are complementary and the optimal evaluation should include both modalities.

Abstracted by: Akshay Kumar Saxena E-mail: fatakshay@yahoo.com
Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
6.0 s, respectively. The authors concluded that POCUS is a rapid and reliable method for identifying endotracheal tube placement in the neonatal population.
Pediatric empyema: are ultrasound characteristics at the time of intervention predictive of reintervention? Haggie S, Selvadurai H, Gunasekera H et al Pediatr Pulmonol (2022) 57:1643-1650 Empyema and parapneumonic effusions are common complications of community-acquired pneumonia in children.
Invasive treatment options include chest drainage with fibrinolytic therapy or video-assisted thoracoscopic surgery (VATS). US findings are important in guiding appropriate intervention in the treatment of empyema in children. In this retrospective study of 129 children with complicated pneumonia, the authors evaluated whether US characteristics of the pleural fluid at the time of chest drainage with fibrinolytic therapy can predict the future need for reintervention. Two senior consultant pediatric interventional radiologists evaluated the sonographic features: echogenicity of the fluid, septations, loculations, visceral pleural thickness and depth of fluid. The radiologists also subjectively predicted whether each child was at high risk for reintervention, defined as any follow-up invasive procedure after the primary chest drainage. Interobserver reliability was moderate for number of septations; weak for size of largest locule; and minimal for fluid echogenicity, pleural thickening, depth of effusion and radiologist's subjective prediction for risk of reintervention. The authors concluded that among the children in their large cohort managed with chest drainage and fibrinolytic therapy, the US characteristics that they evaluated were not predictive of the eventual need for reintervention.