Point-of-care thoracic ultrasound at the patient’s bedside has increased significantly recently, especially in pediatric settings. Its low cost, rapidity, simplicity, and repeatability make it a practical examination to guide diagnosis and treatment choices, especially in pediatric emergency departments. The fields of application of this innovative imaging method are many and include primarily the study of lungs but also that of the heart, diaphragm, and vessels. This manuscript aims to describe the most important evidence for using thoracic ultrasound in the pediatric emergency setting.

Objective: Our aim was to evaluate the safety of COVID-19 vaccine in children resident in the Latina Local Health Authority. Methods: We conducted a telephone survey among children aged 5–11 years receiving BNT162b2 mRNA COVID-19 vaccine between December 15 and 21. The main outcomes included the presence of allergic reactions or anaphylaxis, adverse events after 24–48 h, 7 and 20 days of taking the first and second doses of medications, and documented SARS-CoV-2 infection after vaccination. The information obtained was automatically linked to a spreadsheet and analyzed. Results: 569 children were enrolled. The mean age was 114 ± 4.24 months; there were 251 males in the study. The vaccine showed a favorable safety profile; no anaphylaxis or serious adverse events were reported. The most common symptoms both after the first and second dose were injection site reactions, asthenia, and headache. Injection site reactions were more frequent after the first dose (p = 0.01), while systemic symptoms were more frequent after the second dose (p = 0.022). These symptoms were more frequent in patients with comorbidities (p = 0.0159). Conclusion: Our findings confirm the safety of COVID-19 vaccine in children younger 11 years and could be useful to promote its diffusion in pediatric ages in order to achieve “herd immunity” and prevent the virus’s circulation.

Objectives: We compared the number of accesses, causes, and instrumental evaluations of chest pain in children between the pre-COVID-19 era and the COVID-19 period and analyzed the assessment performed in children with chest pain, highlighting unnecessary examinations. Methods: We enrolled children with chest pain admitted to our emergency department between January 2019 and May 2021. We collected demographic and clinical characteristics and findings on physical examinations, laboratory tests, and diagnostic evaluations. Then, we compared the number of accesses, causes, and instrumental assessments of chest pain between the pre-COVID-19 era and the COVID-19 era. Results: A total of 111 patients enrolled (mean age: 119.8 ± 40.48 months; 62 males). The most frequent cause of chest pain was idiopathic (58.55%); we showed a cardiac origin in 4.5% of the cases. Troponin determination was performed in 107 patients, and the value was high only in one case; chest X-rays in 55 cases and echocardiograms in 25 cases showed pathological findings, respectively, in 10 and 5 cases. Chest pain accesses increased during the COVID-19 era (p < 0.0001), with no differences in the causes of chest pain between the two periods. Conclusions: The increase in accesses for chest pain during the COVID-19 pandemic confirms that this symptom generates anxiety among parents. Furthermore, our findings demonstrate that the evaluation of chest pain is still extensive, and new chest pain assessment protocols in the pediatric age group are needed.

Background: Inguinal hernia repair is a high-volume procedure frequently performed in Day Surgery settings. While local anesthesia is often considered the gold standard, its feasibility is limited in complex cases or due to patient refusal, necessitating alternatives like general (GA) or spinal anesthesia (SA). This study evaluates the impact of these techniques on acute pain, complications, and chronic postoperative inguinal pain (CPIP). Methods: A retrospective observational study was conducted on 73 adult patients undergoing unilateral Lichtenstein hernioplasty (GA = 24; SA = 49). Pain was assessed using the Numeric Rating Scale (NRS) at discharge (T0), 24 h (T1), 7 days (T2), and 180 days (T3). Postoperative complications, rescue analgesic consumption, and perceived time to recovery were recorded. A multivariable linear regression analysis was performed to adjust pain outcomes for age, sex, and ASA status. Results: GA patients reported significantly lower median NRS scores at T0, T1, and T2 in univariate analysis (p < 0.05). However, the multivariable model did not show statistical significance for anesthetic technique as an independent predictor. Constipation was the most frequent complication (35.6%), while nausea occurred only in the SA group (10.2%). Descriptive data showed a trend toward lower rescue analgesic needs and a faster perceived time to recovery in the GA group compared to SA. CPIP incidence was remarkably low (2.7%). Conclusions: GA is a valid alternative to SA in Day Surgery, showing a clinical trend toward better early pain control, lower analgesic consumption, and improved recovery perception, although multivariable analysis did not reach statistical significance.

Background: Liver enzyme abnormalities are common in critically ill patients, but the prognostic relevance of graded aminotransferase elevation and its timing remains uncertain. We evaluated whether Liver Enzyme Elevation (LEE) grade at ICU admission provides prognostic information beyond SAPS II in a heterogeneous ICU cohort. Methods: In this single-centre retrospective study, adult patients admitted to a mixed ICU between January 2023 and December 2024 and with ICU length of stay ≥72 h were analysed. LEE grade was assigned from AST and ALT according to predefined multiples of the local upper limit of normal, using the higher grade reached by either enzyme. The primary outcome was ICU mortality. Secondary outcomes included renal replacement therapy, ICU length of stay, and duration of invasive mechanical ventilation. A fixed logistic model including SAPS II and admission LEE grade was internally validated by bootstrap resampling. Results: Among 274 patients, ICU mortality was 27.7%. Admission LEE grade showed an adjusted association with ICU mortality (OR 1.26 per grade increase, 95% CI 1.00–1.58; p = 0.048), while SAPS II remained the dominant predictor (OR 1.04 per point, 95% CI 1.02–1.06; p < 0.001). Adding admission LEE grade to SAPS II yielded a small absolute increase in discrimination (AUC 0.737 vs. 0.703; DeLong p = 0.039). Bootstrap-corrected AUC was 0.730, with acceptable overall calibration. Admission LEE grade was also associated with RRT and longer ICU stay in exploratory secondary analyses. Conclusions: Admission LEE grade may provide modest complementary prognostic information beyond SAPS II. These findings are exploratory and require external validation before clinical implementation.

Introduction: The use of fibrobronchoscopy increased significantly for collecting airway microbiological samplesand during percutaneous tracheostomies and difficult intubations. Reusable bronchoscopes pose risks of contamination and damage due to their fragile structure and difficulties of cleaning and sterilization; single-use bronchoscopes have been introduced, offering reliability in terms of vision, maneuverability, suctioning capacity, and sterility, reducing the risk of hospital-acquired infections and improving logistical management.Methods: The study analyzed healthcare workers’ and management’s perceptions of single-use bronchoscopesversus reusable ones. Among the main objectives were to evaluate the organizational impact, quality, and performance of bronchoscopes, while also analyzing opinions on device features, safety in infection prevention, and ease of use during training.Results: In this analysis 66% of clinicians rated optimal image quality, and 90% of respondents highly appreciatedthe “plug & play” feature of disposable endoscopes; also, 45% of clinicians noted no significant differences in aspiration performance. Healthcare professionals felt more exposed to infectious agents with reusable endoscopes, believing disposable endoscopes required less vigilance and monitoring. In training, 80% of doctors and 100% of nurses considered disposable endoscopes more suitable due to their greater ease of use. Finally, the Overall Satisfaction of all healthcare workers was 75%.Conclusion: The analysis of results demonstrated that the use of single-use bronchoscopes in anesthesia andresuscitation is highly comparable in terms of clinical effectiveness to reusable ones and that significant advantages in costs and organizational impact were highlighted, positively impacting the daily workflow of healthcare workers.