Lung Ultrasound in Community-Acquired Pneumonia and in Interstitial Lung Diseases

Reißig, Angelika; Copetti, Roberto

doi:10.1159/000357449

Cited by 92 publications

(108 citation statements)

References 45 publications

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“…3,27 To identify pneumonia by LUS, a consolidation needs to reach the pleura and be within an intercostal window. 28 In children, the former is offset by the relative small lung size, 26 as mentioned previously, and may explain the relative high sensitivity found in our results. Conversely, when features typical of pneumonia are identified on LUS, it may be a result of noninfiltrative processes including atelectasis.…”

Section: Figuresupporting

confidence: 64%

“…Specifically, the smaller thoracic diameter and lung volume of children and neonates permit better visualization with LUS. 26,29 Similarly, the spectrum of disease found in children may differ from that seen in the adult population, necessitating different standards in both diagnosis and treatment. 3,27 To identify pneumonia by LUS, a consolidation needs to reach the pleura and be within an intercostal window.…”

Section: Figurementioning

confidence: 99%

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Lung Ultrasound for the Diagnosis of Pneumonia in Children: A Meta-analysis

et al. 2015

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BACKGROUND AND OBJECTIVE: Pneumonia is the leading cause of death of children. Diagnostic tools include chest radiography, but guidelines do not currently recommend the use of lung ultrasound (LUS) as a diagnostic method. We conducted a meta-analysis to summarize evidence on the diagnostic accuracy of LUS for childhood pneumonia. METHODS:We performed a systematic search in PubMed, Embase, the Cochrane Library, Scopus, Global Health, World Health Organization-Libraries, and Latin American and Caribbean Health Sciences Literature of studies comparing LUS diagnostic accuracy against a reference standard. We used a combination of controlled key words for age ,18 years, pneumonia, and ultrasound. We identified 1475 studies and selected 15 (1%) for further review. Eight studies (765 children) were retrieved for analysis, of which 6 (75%) were conducted in the general pediatric population and 2 (25%) in neonates. Eligible studies provided information to calculate sensitivity, specificity, and positive and negative likelihood ratios. Heterogeneity was assessed by using Q and I 2 statistics.RESULTS: Five studies (63%) reported using highly skilled sonographers. Overall methodologic quality was high, but heterogeneity was observed across studies. LUS had a sensitivity of 96% (95% confidence interval [CI]: 94%-97%) and specificity of 93% (95% CI: 90%-96%), and positive and negative likelihood ratios were 15.3 (95% CI: 6.6-35.3) and 0.06 (95% CI: 0.03-0.11), respectively. The area under the receiver operating characteristic curve was 0.98. Limitations included the following: most studies included in our analysis had a low number of patients, and the number of eligible studies was also small. Dr Pereda conceptualized and designed the study, reviewed all abstracts and selected articles to be included in the meta-analysis, was responsible for data collection, and drafted the initial manuscript; Dr Chavez conceptualized and designed the study, reviewed all abstracts and selected articles to be included in the meta-analysis, was responsible for data collection, led the analysis, and drafted the initial manuscript; Dr Hooper-Miele participated in analysis and interpretation of results, critically revised ultrasound methods used by selected studies, and reviewed and revised the manuscript; Drs Gilman, Steinhoff, Ellington, and Tielsch participated in the analysis and interpretation of results and reviewed and revised the manuscript; Ms Gross and Ms Price conducted the literature search and reviewed and revised the manuscript; Dr Checkley conceptualized and designed the study, contributed equally to the analysis, drafted the initial manuscript, and had ultimate oversight over the study conduct, analysis plan, and writing of the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.www.pediatrics.org/cgi

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Section: Figuresupporting

confidence: 64%

Section: Figurementioning

confidence: 99%

Lung Ultrasound for the Diagnosis of Pneumonia in Children: A Meta-analysis

et al. 2015

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“…However, results are in agreement with other single-center studies in similar populations. Furthermore, in a multicenter study, Reissig et al [5] and Reissig and Copetti [10] provided similar results with a sensitivity of 93% and a specificity of 98% for the sonographic diagnosis of pneumonia.…”

Section: Discussionmentioning

confidence: 70%

Can Lung Ultrasound Replace Chest Radiography for the Diagnosis of Pneumonia in Hospitalized Children?

et al. 2014

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Background: Lung ultrasound is a non-radiating accurate alternative tool to chest X-ray (CXR) in the diagnosis of community-acquired pneumonia (CAP) in adults. Objectives: The aim of our study was to define the accuracy of ultrasound in the diagnosis of CAP in children. Methods: 107 consecutive children with suspected CAP underwent clinical examination, blood sample analysis, CXR and lung ultrasound on admission to the Pediatric Department of the San Paolo Hospital. The diagnosis of pneumonia was made by an independent committee of physicians on the basis of the overall clinical and CXR data. Results: The diagnosis of CAP was confirmed by the committee in 81 patients (76%). Ultrasound and CXR were performed in all patients. Ultrasound had a sensitivity of 94% and specificity of 96%, while CXR showed a sensitivity of 82% and a specificity of 94%. In patients with CAP, ultrasound revealed subpleural consolidations with air bronchogram in 70 cases and focal B-lines in 6. A parapneumonic pleural effusion was detected in 17 patients by ultrasound, while only 11 of them could be detected by CXR. Conclusions: In our series, lung ultrasound was highly accurate for the diagnosis of CAP in hospitalized children. These results provide the rationale for a multicenter study in children.

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“…Specific applications of LUS may include dynamically monitoring of the response to treatment (15) and excluding other causes of acute respiratory distress in the emergency setting, such as heart failure (16), pneumothorax (14), pleural effusion (17), alveolar pneumonia (18).…”

Section: Discussionmentioning

confidence: 99%

Strong correlation between lung ultrasound and chest computerized tomography imaging for the detection of acute lung injury/acute respiratory distress syndrome in rats

Huang

Guo³

et al. 2016

J. Thorac. Dis.

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Background: Lung ultrasound (LUS) is a clinical imaging technique for diagnosing acute lung injury (ALI)and acute respiratory distress syndrome (ARDS). In humans and several large animals, LUS demonstrates similar specificity and sensitivity to computerized tomography (CT) scanning. Current study evaluated the degree of agreement between LUS and CT imaging in characterizing ALI/ARDS in rats.Methods: Thirty male Sprague-Dawley rats were imaged by LUS before randomization into three groups to receive intratracheal saline, 3 or 6 mg/kg LPS respectively (n=10). LUS and CT imaging was conducted 2 hours after instillation. Cross table analyses and kappa statistics were used to determine agreement levels between LUS and CT assessments of lung condition.Results: Before instillation, rats presented with a largely A-pattern in LUS images, however, a significantly increase B-lines were observed in all groups after instillation and showed dose response to LPS or to saline.One rat treated with 6 mg/kg lipopolysaccharide (LPS) presented with lung consolidation. The agreement between the LUS and the CT in detecting the main characteristics of ALI/ARDS in rat was strong (r=0.758, P<0.01, k=0.737). Conclusions:In conclusion, LUS detects ALI/ARDS with high agreement with micro PET/CT scanning in a rat model, suggesting that LUS represents a positive refinement in rat ALI/ARDS disease models.

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Lung Ultrasound in Community-Acquired Pneumonia and in Interstitial Lung Diseases

Cited by 92 publications

References 45 publications

Lung Ultrasound for the Diagnosis of Pneumonia in Children: A Meta-analysis

Lung Ultrasound for the Diagnosis of Pneumonia in Children: A Meta-analysis

Can Lung Ultrasound Replace Chest Radiography for the Diagnosis of Pneumonia in Hospitalized Children?

Strong correlation between lung ultrasound and chest computerized tomography imaging for the detection of acute lung injury/acute respiratory distress syndrome in rats

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