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

Abstract Objectives To present lung ultrasoundfindings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasoundin 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 ultrasoundwas performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings. Community acquired pneumoniawas 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 ultrasoundfindings 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 ultrasoundin 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 ultrasoundin seven (4.6%) patients, findings compatible with pneumonia were not determined at chest X-ray in two of these patients. When lung ultrasoundand chest X-ray were compared as diagnostic tools, a significant difference was observed between them ( p =0.041). Conclusions This study shows that lung ultrasoundis at least as useful as chest X-ray in diagnosing children with community-acquired pneumonia.