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Respiratory failure is one of the most common and critical problems in pediatric wards. Assessments by chest X-rays (CXRs) are common and prevalent for determining the cause of respiratory failure in children. However, CXRs can be misinterpretated. Some patients may require further evaluation with other tools, such as chest computed tomography (CCT). Lung ultrasound (LUS) has proven useful for detecting lung abnormalities with respiratory failure in adults, but its usefulness in children is still not clear. We present a series of eight children who were admitted in a tertiary children's hospital. Each child underwent CXR, CCT, and LUS. In seven of eight cases, both LUS and CCT were able to detect abnormal findings. However, the radiological findings in CXRs were not sufficient. These cases included children with pleural effusion that was comorbid with consolidation, or cases with substantial consolidation that required thoracentesis or proper physical therapy. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to verify the screening performance of our clinical prediction rule for neurological sequelae due to acute encephalopathy (NSAE-CPR), which previously identified the following three variables as predictive of poor outcomes: (1) refractory status epilepticus; (2) consciousness disturbance and/or hemiplegia at 6 hours from onset and (3) aspartate aminotransferase >90 IU/L within 6 hours of onset. Design Medical community-based multicentre retrospective cohort study. Setting Six regional hospitals in Harima and one tertiary centre in Kobe, Japan, from 2008 to 2012. Participants We enrolled a total of 1612 patients aged <16 years who met the diagnostic criteria for an initial diagnosis of complex febrile seizure. Patients with a history of neurological disease and those included in the derivation cohort were excluded. Primary outcome measures Univariate and multivariate analyses were performed to determine the association between each of the three predictor variables and poor AE outcome (Pediatric Cerebral Performance Category score =2). Receiver operating characteristic curve (ROC) analysis was also performed to assess the screening performance of the NSAE-CPR. Results The ROC analysis identified at least one of the three predictive variables as an optimal cut-off point, with an area under the curve of 0.915 (95% CI 0.825 to 1.000). The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and Matthews correlation coefficient were 0.867, 0.954, 0.149, 0.999, 18.704, 0.140 and 0.349, respectively. Conclusions Our findings indicate that the NSAE-CPR can be used for the screening and identification of patients with poor outcomes due to acute encephalopathy within 6 hours of onset. [ABSTRACT FROM AUTHOR]