Quantitative Analysis of Lung Ultrasonography for the Detection of Community-Acquired Pneumonia: A Pilot Study

Corradi, Francesco; Brusasco, Claudia; Garlaschi, Alessandro; Paparo, Francesco; Ball, Lorenzo; Santori, Gregorio; Pelosi, Paolo; Altomonte, F; Vezzani, Antonella; Brusasco, Vito

doi:10.1155/2015/868707

Cited by 44 publications

(48 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast to our study, Francesco et al (17) found that the sensitivity of LUS in identifying parenchymal consolidation was much lower than previously reported (59 versus 88-95%) (21,26,27). In a previous study of critically ill patients (28), LUS had a high accuracy in detecting consolidations due to different causes, which was explained by the fact that most of these reached the pleura.…”

Section: Diagnosis Of Pneumonia In Adultscontrasting

confidence: 99%

See 1 more Smart Citation

Implementation of chest ultrasound with color Doppler in diagnosis of pneumonia in adults

Kader

Osman

2016

The Egyptian Journal of Radiology and Nuclear Medicine

View full text Add to dashboard Cite

Objective: To evaluate the role of color Doppler sonography in comparison with CXR and CT imaging in diagnosis of pneumonia in adults. Patients and methods: Thirty-one patients with clinical suspicion of pneumonia were assessed by chest radiography, CT and sonography. Quantitative and qualitative sonographic examination of lesions was performed using color Doppler imaging. The correlation between color Doppler and CT findings was determined. Results: Lung ultrasound showed high sensitivity (100%), specificity (93.8%) and diagnostic accuracy 96.8% in diagnosis of pneumonia. It detected air bronchogram in all cases, simple effusion in 18 cases and effusion with internal echoes in 8 cases. It was almost agreement with CT findings (K = 0.93). The sensitivity of chest X-ray was low (60%). It was moderate agreement with CT findings (K = 0.608). A significant changes were seen in flow pattern in comparison with severity of necrosis by CT (P value = 0.038). Majority of our cases reflected pulmonary arterial flow pattern that was found in 21 cases. Conclusion: Lung ultrasound with color Doppler imaging is highly accurate and valid alternatively in diagnosis of pneumonia. By qualitative and quantitative impedance measurement, pulmonary and bronchial arteries can be differentiated. The flow pattern of pulmonary arteries was an indicative of good outcome.

show abstract

Section: Diagnosis Of Pneumonia In Adultscontrasting

confidence: 99%

“…In a previous recent study (16), quantitative lung ultrasonography (QLUS) proved to be an accurate method to evaluate extravascular lung water in a model of pulmonary edema. It can be hypothesized that QLUS may also be useful for detection of pulmonary consolidations of different origins (17).…”

Section: Introductionmentioning

confidence: 99%

Implementation of chest ultrasound with color Doppler in diagnosis of pneumonia in adults

Kader

Osman

2016

The Egyptian Journal of Radiology and Nuclear Medicine

View full text Add to dashboard Cite

show abstract

“…By contrast, the false negative results usually occurred when the consolidation was located far away from pleura and hided deep in the lung parenchyma. In addition, quantitative LUS (QLUS) was evident to be an impressive approach of pneumonia detection, showing a higher sensitivity and specificity than regular LUS (23). The combination of LUS and microbiological gram stain caused a conclusive increase in the likelihood of pneumonia diagnosis (26).…”

Section: Discussionmentioning

confidence: 99%

“…Among all 14 studies, 11 were carried out in emergency department (ED) or medical wards (10,(15)(16)(17)(18)(19)(20)(22)(23)(24)(25), and 3 were conducted in intensive care unit (ICU) (14,21,26). Hemithorax was used as the study unit for result interpretation in one study (23), while others counted by patient.…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of lung ultrasonography for diagnosis of pneumonia in adults: a systematic review and meta-analysis

Yang¹,

Ying²,

Wang³

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: Pneumonia is usually presented as a forgotten killer, and an early diagnosis could largely improve the prognostic outcomes. Lung ultrasound (LUS) has been universally applied in evaluating multiple pulmonary diseases including pneumonia. However, the diagnosis accuracy of LUS for pneumonia in adults is still uncertain. Hence, we performed a systematic review of the current literature to assess the diagnosis accuracy of LUS for pneumonia in adults.Methods: PubMed and EMBASE were searched for clinical trials that assessed the detection accuracy of LUS for pneumonia in adult patients. We extracted descriptive and quantitative information from eligible studies that met strict inclusion criteria and calculated pooled sensitivity, specificity and pooled diagnostic likelihood ratios (LR). Summary receiver operating characteristic (sROC) curve was used to assess the overall performance of LUS-based assays.Results: We reviewed 1,072 articles and selected 38 for detailed review. 14 articles containing 1,911 participants met all inclusion criteria and were included in the final analysis. LUS exhibited a pooled sensitivity of 0.904 (0.884-0.921), specificity of 0.884 (0.861-0.904), positive LR of 6.6 (3.7-11.7), negative LR of 0.08 (0. 04-0.19) and the area under curve (AUC) was 0.9611. Interestingly, when CT alone, CT combined with clinical presentations, and microbiology was set as the gold standard of pneumonia respectively, LUS demonstrated a pooled sensitivity of 90.9%, 95.0%, 53.3%, and a pooled specificity of 89.7%, 91.3% and 67.9%. In extension, we compared the diagnostic efficiency of LUS for pneumonia with chest X-ray (CXR) in 1,343 patients. The AUC for LUS and CXR was 0.972 and 0.867 respectively and the Z statistic of the two sROC curves was 2.31.Conclusions: Our study indicated that LUS is a robust diagnostic tool for pneumonia with high accuracy.Utilization of LUS would facilitate the estimation of pneumonia at bedside. be based on swift and accurate recognition. The signs and symptoms localizing to the respiratory system, commonly referring as dyspnea, cough and fever, laboratory alterations (leukocytosis and increased c-reactive protein/procalcitonin) in conjunction with radiographic pulmonary infiltrate, point to convincing diagnosis of pneumonia. Imaging evaluation approaches recommended on current guidelines are chest radiograph and chest computerized tomography (CT) (2,3). However, limitations for their use exist (4). Surprisingly, a recent study compared CXR to chest CT scan for suspected CAP. They found up to 30% false positive and false negative rate of CXR in emergency department (ED), which doubted the value of CXR on pneumonia diagnosis (5). Thus, it's reasonable to figure out the alternative way to provide promising imaging evidence of pneumonia.Ultrasonography is gaining more attention in critical care and emergency medicine. A good body of studies has proven that ultrasonography is highly effective in evaluating multiple pulmonary diseases, such as metastatic lymph node of lung c...

show abstract

Community-Acquired Pneumonia

Vaughn,

Dickson,

Horowitz

et al. 2024

JAMA

View full text Add to dashboard Cite

ImportanceCommunity-acquired pneumonia (CAP) results in approximately 1.4 million emergency department visits, 740 000 hospitalizations, and 41 000 deaths in the US annually.ObservationsCommunity-acquired pneumonia can be diagnosed in a patient with 2 or more signs (eg, temperature &gt;38 °C or ≤36 °C; leukocyte count &lt;4000/μL or &gt;10 000/μL) or symptoms (eg, new or increased cough or dyspnea) of pneumonia in conjunction with consistent radiographic findings (eg, air space density) without an alternative explanation. Up to 10% of patients with CAP are hospitalized; of those, up to 1 in 5 require intensive care. Older adults (≥65 years) and those with underlying lung disease, smoking, or immune suppression are at highest risk for CAP and complications of CAP, including sepsis, acute respiratory distress syndrome, and death. Only 38% of patients hospitalized with CAP have a pathogen identified. Of those patients, up to 40% have viruses identified as the likely cause of CAP, with Streptococcus pneumoniae identified in approximately 15% of patients with an identified etiology of the pneumonia. All patients with CAP should be tested for COVID-19 and influenza when these viruses are common in the community because their diagnosis may affect treatment (eg, antiviral therapy) and infection prevention strategies. If test results for influenza and COVID-19 are negative or when the pathogens are not likely etiologies, patients can be treated empirically to cover the most likely bacterial pathogens. When selecting empirical antibacterial therapy, clinicians should consider disease severity and evaluate the likelihood of a bacterial infection—or resistant infection—and risk of harm from overuse of antibacterial drugs. Hospitalized patients without risk factors for resistant bacteria can be treated with β-lactam/macrolide combination therapy, such as ceftriaxone combined with azithromycin, for a minimum of 3 days. Systemic corticosteroid administration within 24 hours of development of severe CAP may reduce 28-day mortality.ConclusionsCommunity-acquired pneumonia is common and may result in sepsis, acute respiratory distress syndrome, or death. First-line therapy varies by disease severity and etiology. Hospitalized patients with suspected bacterial CAP and without risk factors for resistant bacteria can be treated with β-lactam/macrolide combination therapy, such as ceftriaxone combined with azithromycin, for a minimum of 3 days.

show abstract

Quantitative Analysis of Lung Ultrasonography for the Detection of Community-Acquired Pneumonia: A Pilot Study

Cited by 44 publications

References 38 publications

Implementation of chest ultrasound with color Doppler in diagnosis of pneumonia in adults

Implementation of chest ultrasound with color Doppler in diagnosis of pneumonia in adults

Effectiveness of lung ultrasonography for diagnosis of pneumonia in adults: a systematic review and meta-analysis

Community-Acquired Pneumonia

Contact Info

Product

Resources

About