Sonographic Diagnosis and Follow-Up of Pneumonia: A Prospective Study

Reißig, Angelika; Kroegel, Claus

doi:10.1159/000100427

Cited by 122 publications

(89 citation statements)

References 28 publications

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“…Previous studies performed both in children and adults have shown that LUS is not inferior to chest radiographs in identifying lung abnormalities in patients with a clinical suspicion of pneumonia [15,16,18,19,[21][22][23][24]. Urbanowska et al [19] showed a high agreement between LUS and chest radiographs, with a Cohen kappa coefficient of agreement of 0.89.…”

Section: Se % (95%ci) Sp % (95%ci) Ppv% (95%ci) Npv % (95%ci) Plr (95mentioning

confidence: 96%

Performance of lung ultrasonography for the diagnosis of communityacquired pneumonia in hospitalized children

et al. 2017

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Aims: The objective of the study was to assess the performance of lung ultrasonography (LUS) as compared to chest radiography and the clinical criteria for the diagnosis of pneumonia in children.Materials and methods: This was a retrospective study in which data were collected from medical files of 81 children admitted with a clinical suspicion of pneumonia in which both an LUS and a chest radiograph during the hospitalization were performed. Reference standard used for the diagnosis of pneumonia were chest radiographs (consolidation, parenchymal infiltrates, and interstitial infiltrate) and clinical criteria. LUSfindings were reported as normal, parenchymal consolidations and pleural effusions. Results: Radiological pneumonia was reported in 72 of the 81 patients (88.9%). LUS identified parenchymal consolidations in 62 cases. LUS correctly identified radiological pneumonia with a sensitivity of 79.2% and a specificity of 44.4%. The positive predictive value (PPV) was 91.9% and the negative predictive value (NPV) was 21.0%. When clinical criteria were used as reference standard, the sensitivity, specificity, PPV and NPV of correctly identifying clinical pneumonia cases by LUS (only consolidations) were 80.0%, 66.7%, 96.8% and 21.0%. When indicative for the presence of pneumonia either the ultrasound consolidation or the ultrasound detected pleural effusion were considered when the sensitivity, PPV and NPV increased to 96.0% (95%CI: 88.8-99.2), 97.3% (95%CI: 92.0-99.1), and 57.1% (95%CI: 27.7-82.2), respectively.Conclusions: In our opinion, our findings together withprevious ones available in the literature recommend LUS as a valuable investigation for the diagnosis of community-acquiredpneumonia in children.

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Section: Se % (95%ci) Sp % (95%ci) Ppv% (95%ci) Npv % (95%ci) Plr (95mentioning

confidence: 96%

Performance of lung ultrasonography for the diagnosis of communityacquired pneumonia in hospitalized children

et al. 2017

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“…The cause of lung consolidation can be diagnosed by analyzing the sonographic features of the lesion [39,40]. Accuracy of lung ultrasound in the diagnosis and differential diagnosis of lung consolidation has been tested in different settings [36,[41][42][43][44] and showed good accuracy compared with CXR [43,[45][46][47][48]. In pleuritic pain, lung ultrasound is superior to CXR and may allow visualization of radio-occult pulmonary conditions [47,48].…”

Section: B-d4-s9 (No Consensus: Level N/a)mentioning

confidence: 99%

International evidence-based recommendations for point-of-care lung ultrasound

et al. 2012

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Background: The purpose of this study is to provide evidence-based and expert consensus recommendations for lung ultrasound with focus on emergency and critical care settings. Methods: A multidisciplinary panel of 28 experts from eight countries was involved. Literature was reviewed from January 1966 to June 2011. Consensus members searched multiple databases including Pubmed, Medline, OVID, Embase, and others. The process used to develop these evidence-based recommendations involved two phases: determining the level of quality of evidence and developing the recommendation. The quality of evidence is assessed by the grading of recommendation, assessment, development, and evaluation (GRADE) method. However, the GRADE system does not enforce a specific method on how the panel should reach decisions during the consensus process. Our methodology committee decided to utilize the RAND appropriateness method for panel judgment and decisions/consensus. Results: Seventythree proposed statements were examined and discussed in three conferences held in Bologna, Pisa, and Rome. Each conference included two rounds of face-to-face modified Delphi technique. Anonymous panel voting followed each round. The panel did not reach an agreement and therefore did not adopt any recommendations for six statements. Weak/ conditional recommendations were made for 2 statements, and strong recommendations were made for the remaining 65 statements. The statements were then recategorized and grouped to their current format. Internal and external peer-review processes took place before submission of the recommendations. Updates will occur at least every 4 years or whenever significant major changes in evidence appear. Conclusions: This document reflects the overall results of the first consensus conference on ''point-of-care'' lung ultrasound. Statements were discussed and elaborated by experts who published the vast majority of papers on clinical use of lung ultrasound in the last 20 years. Recommendations were produced to guide implementation, development, and standardization of lung ultrasound in all relevant settings.

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“…Lung sonography is a non-radiating imaging tool. It has been shown that lung ultrasound helps to identify subpleural lung consolidation in pneumonia [4], and, recently, a multicenter study proved the accuracy of the technique in the sonographic diagnosis of CAP in adults [5]. In our respiratory ward, we routinely perform lung ultrasound as consultants for the Pediatric Department.…”

Section: Introductionmentioning

confidence: 99%

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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Sonographic Diagnosis and Follow-Up of Pneumonia: A Prospective Study

Cited by 122 publications

References 28 publications

Performance of lung ultrasonography for the diagnosis of communityacquired pneumonia in hospitalized children

Performance of lung ultrasonography for the diagnosis of communityacquired pneumonia in hospitalized children

International evidence-based recommendations for point-of-care lung ultrasound

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

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