The value of chest radiograph in the first episode of acute bronchiolitis

Abstract

Introduction: We present the results of a prospective study about the benefit of the routine chest x-ray of infants hospitalized for a first episode of acute bronchiolitis and establish the clinical predictors of radiographic abnormalities.

Study design: All infants hospitalized in the pediatric unit (P1) with a first episode of acute bronchiolitis from September 2015 to February 2016, and who have benefited from a chest x-ray, were included in the study.

Results: One hundred and twenty eight (128) infants were included in our study (median age of 11 months, with 66.7% boys).  The chest radiograph revealed thoracic distension (72%), bronchial syndrome (79%), condensation syndrome (6.3%) and ventilation disturbances (31%).  This chest x-ray resulted in changes to patient treatments (antibiotics) in 6.3% of the cases, but has not allowed any differential diagnosis. However, oxygen saturation lower than 94% and digestive disorders were good predictors of radiographic abnormalities.

Conclusion: Chest x-rays yield non-specific information, and do not help differentiate between viral and bacterial infections. Oxygen saturation (SpO2) lower than 94% is the only severity factor that predicts radiographic abnormalities. Chest x-ray has practically no value in the case of children wheezing for first time. The radiographic anomalies may result a non-indicated prescription of antibiotics.