Point-of-care lung ultrasound in children with community acquired pneumonia

Am J Emerg Med. 2017 Jul;35(7):964-969. doi: 10.1016/j.ajem.2017.01.065. Epub 2017 Feb 1.

Abstract

Objectives: To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays.

Methods: This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings. Community acquired pneumonia was established as a final diagnosis by two clinicians based on the recommendations in the British Thoracic Society guideline.

Results: One hundred sixty children with a mean age of 3.3±4years and a median age of 1.4years (min-max 0.08-17.5years) were investigated. Final diagnosis in 149 children was community-acquired pneumonia. Lung ultrasound findings were compatible with pneumonia in 142 (95.3%) of these 149 children, while chest X-ray findings were compatible with pneumonia in 132 (88.5%). Pneumonia was confirmed with lung ultrasound in 15 of the 17 patients (11.4%) not evaluated as compatible with pneumonia at chest X-ray. While pneumonia could not be confirmed with lung ultrasound in seven (4.6%) patients, findings compatible with pneumonia were not determined at chest X-ray in two of these patients. When lung ultrasound and chest X-ray were compared as diagnostic tools, a significant difference was observed between them (p=0.041).

Conclusions: This study shows that lung ultrasound is at least as useful as chest X-ray in diagnosing children with community-acquired pneumonia.

Keywords: Children; Community-acquired pneumonia; Point of care lung ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Community-Acquired Infections / diagnostic imaging*
  • Community-Acquired Infections / physiopathology
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lung / diagnostic imaging*
  • Male
  • Pleural Effusion / diagnostic imaging*
  • Pneumonia / diagnostic imaging*
  • Pneumonia / physiopathology
  • Point-of-Care Systems*
  • Predictive Value of Tests
  • Prospective Studies
  • Radiography, Thoracic*
  • Sensitivity and Specificity
  • Turkey
  • Ultrasonography*