Bedside lung ultrasound useful option for accurate diagnosis of pneumonia in kids

A recent study published in the International Journal of Emergency Medicine found that bedside Lung ultrasound (LUS) when used by clinicians of the Emergency Department (ED) of a resource limited healthcare setup, had good accuracy for diagnosis of pneumonia in children.

Pneumonia is the leading cause of death in children under 5 years of age in such settings and so the team lead by Yogendra Amatya undertook this prospective cross-sectional study in children presenting to an ED with respiratory complaints.

The study included all children under 5 years of age with cough, fever, or difficulty breathing who received a chest radiograph. A bedside LUS was performed and interpreted by the treating clinician on all children prior to chest radiograph. The criterion standard was radiographic pneumonia, diagnosed by a panel of radiologists using the Chest Radiography in Epidemiological Studies methodology.

The key highlights of the study were:

The study enrolled 366 children with a median age of 16.5 months and 57.3% were male. 84 patients (23%) were diagnosed with pneumonia by chest X-ray.

The sensitivity, specificity, positive and negative likelihood ratios for clinician’s LUS interpretation was 89.3% (95% CI 81–95), 86.1% (95%CI 82–90), 6.4, and 0.12 respectively.

LUS demonstrated good diagnostic accuracy for pneumonia with an area under the curve of 0.88 (95% CI 0.83–0.92). Interrater agreement between clinician and expert ultrasound interpretation was excellent (k = 0.85).

In conclusion, the findings of this study suggests that, LUS may be a useful diagnostic tool in resource-limited settings where access to advanced imaging technology is limited.

Source:

Amatya, Y., Russell, F. M., Rijal, S., Adhikari, S., Nti, B., & House, D. R. (2023). Bedside lung ultrasound for the diagnosis of pneumonia in children presenting to an emergency department in a resource-limited setting. In International Journal of Emergency Medicine (Vol. 16, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12245-022-00474-w