Utility of lung ultrasound in childhood pneumonia in a tertiary care center
DOI:
https://doi.org/10.18203/2349-3291.ijcp20202071Keywords:
Childhood pneumonia, Consolidation, Lung, Lung ultrasoundAbstract
Background: Pneumonia is a major cause of childhood mortality and morbidity worldwide. Chest radiography has been used as a modality for diagnosing but has the disadvantage of radiation exposure and inter-observer variability. Hence studies have explored the possibility of using lung ultrasound in the diagnosis of pneumonia. To assess lung ultrasound (LUS) findings in childhood pneumonia and to correlate lung ultrasound findings with clinical findings.
Methods: 210 children between 2 months to 5 years admitted in the hospital with diagnosis of pneumonia were enrolled in the study. They underwent LUS within 24 hours of admission and the results were analysed.
Results: Out of the 210 patients enrolled in the study, 41 (19.5%) had positive LUS findings. However, LUS findings correlated well with clinical findings in cases with very severe pneumonia.
Conclusions: This study showed that lung ultrasound cannot be used a sole diagnostic tool in childhood pneumonia, but it has a valuable role in detection of complications. Lung ultrasound will require more training for detection of early indicators of pneumonia.
References
Kelly MS, Sandora TJ. Community Acquired Pneumonia. In: Kleigman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson textbook of paediatrics. 20th ed, Vol 2. New Delhi: Thomson Press; 2015:2088.
Bradley JS, Byrington VL, Shah SS, Alverson B, Carter ER, Harrison C et al. The management of community acquired pneumonia in infants children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53:e25-e76.
Shah S, Bachur R, Kim D, Neuman MI. Lack of predictive value of tachypnea in the diagnosis of pneumonia in children. Pediatr Infect Dis J. 2010;29(5):406-9.
Park MY, Jung SE. Patient Dose Management: Focus on Practical Actions. J Korean Medi Sci. 2016;31(Suppl 1):S45-54.
Copetti R, Cattarossi L. Ultrasound diagnosis of pneumonia in children. Radiol Med. 2008;113:190-8.
Bada C, Carreazo NY, Chalco JP, Huicho L. Inter-observer agreement in interpreting chest X-rays on children with acute lower respiratory tract infections and concurrent wheezing. Sao Paulo Medi J. 2007 May;125(3):150-4.
Johnson J, Kline JA. Intraobserver and interobserver agreement of the interpretation of pediatric chest radiographs. Emerg Radiol. 2010 Jul 1;17(4):285-90.
Edwards M, Lawson Z, Morris S. The presence of radiological features on chest radiographs: how well do clinicians agree? Clin Radiol. 2012;67:664-8.
Levinsky Y, Mimouni FB, Fisher D, Ehrlichman M. Chest radiography of acute paediatric lower respiratory infections: experience versus interobserver variation. Acta Paediatr. 2013 Jul;102(7):e310-4.
Cherian T, Mulholland EK, Carlin JB, Ostensen H, Amin R, Campo MD, et al. Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies. Bull WHO. 2005;83:353-9.
Hagaman JT, Panos RJ, Rouan GW. Admission chest radiograph lacks sensitivity in the diagnosis of community-acquired pneumonia. Am J Med Sci. 2009;337:236-40.
Tanaka N, Emoto T, Suda H, Matsumoto T, Matsunaga N. Community-acquired pneumonia: a correlative study between chest radiographic and HRCT findings. Japan J Radiol. 2015 Jun 1;33(6):317-28.
Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, et al. British Thoracic Society Standards of Care C. 2011. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011;66(Suppl 2):ii1-ii23.
National Collaborating Centre for Women's and Children's Health (UK. Bronchiolitis: diagnosis and management of bronchiolitis in children.
Koh DM, Burke S, Davies N, Padley SP. Transthoracic US of the chest: clinical uses and applications. Radiographics. 2002 Jan;22(1):e1.
Stadler JAM, Andronikou S, Zar HJ. Lung ultrasound for the diagnosis of community-acquired pneumonia in children: Pediatr Radiol. 2017;47:1412-9.
Lichtenstein D, Meziere G, Biderman P, Gepner A, Barre O. The comet-tail artifact: an ultrasound sign of alveolar-interstitial syndrome. Am J Resp Criti Care Medi. 1997 Nov 1;156(5):1640-6.
Martelius L, Heldt H, Lauerma K. B‐lines on pediatric lung sonography: comparison with computed tomography. J Ultrasound Medi. 2016 Jan;35(1):153-7.
Riccabona M. Ultrasound of the chest in children (mediastinum excluded). Eur Radiol. 2008 Feb 1;18(2):390-9.
Toma P. Lung ultrasound in bronchiolitis. Eur J Pediatr. 2013 May 1;172(5):713.
Tomà P, Owens CM. Chest ultrasound in children: critical appraisal. Pediatr Radiol. 2013 Nov 1;43(11):1427-34.
Lichtenstein DA. Lung ultrasound in the critically ill. Ann Inten Care. 2014 Dec;4(1):1.
Chavez MA, Naithani N, Gilman RH, Tielsch JM, Khatry S, Ellington LE, et al. Agreement between the World Health Organization algorithm and lung consolidation identified using point-of-care ultrasound for the diagnosis of childhood pneumonia by general practitioners. Lung. 2015 Aug 1;193(4):531-8.
Ansari MDE, Kumar A, Aggarwal KC, Meena KR, Kamal M. Outcome predictors of severe and very severe pneumonia in children between 2-59 months of age admitted in a tertiary care hospital. Ind J Child Health. 2017;4(1):39-43.
Gothankar J, Doke P, Dhumale G, Pore P, Lalwani S, Quraishi S, et al. Reported incidence and risk factors of childhood pneumonia in India: a community-based cross-sectional study. BMC Pub Health. 2018 Dec;18(1):1-1.
Shekhawat YS, Sharma P, Singh A, Vikas P. Bacteriological and clinical profile of community acquired pneumonia in hospitalised children with associated co-morbidity in a tertiary care centre of Western Rajasthan, India. Int J Contemp Pediatr. 2016 Nov;3(4):1360-84.
Tiewsoh K, Lodha R, Pandey RM, Broor S, Kalaivani M, Kabra SK. Factors determining the outcome of children hospitalized with severe pneumonia. BMC Pediatr. 2009 Dec 1;9(1):15.
Calder A, Owens CM. Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol. 2009 Jun 1;39(6):527-37.
Tirdia PR, Vajpayee S, Singh J, Gupta RK. Accuracy of lung ultrasonography in diagnosis of community acquired pneumonia in hospitalised children as compared to chest x-ray: Int J Contemp Pediatr. 2016 Aug;3(3):1026-31.
Pereda MA, Chavez MA, Hooper-Miele CC, Gilman RH, Steinhoff MC, Ellington LE, et al. Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics. 2015 Apr 1;135(4):714-22.
Kombade B, Komwad A, Patil S, Kadam M. Chest Ultrasound versus chest xrays for detecting pneumonia in children. MedPulse- Int Med J. December 2016;3(12):1102-5.
Shah VP, Tunik MG, Tsung JW. Prospective evaluation of point of care ultrasonography for the diagnosis of pneumonia in children and young adults. JAMA Pediatr. 2013;167:119-25.
Chavez MA, Naithani N, Gilman RH. Agreement between the World Health Organization algorithm and lung consolidation identified using point of care ultrasound for the diagnosis of childhood pneumonia by general practitioners. Lung. 2015;193:531-8.
Claes A-S, Clapuyt P, Menten R. Performance of chest ultrasound in pediatric pneumonia. Eur J Radiol. 2017;88:82-7.
Reali f, Sferrazza Papa GF, Carlucci P. can lung ultrasound replace chest radiography for the diagnosis of pneumonia in hospitalized children? Respiration. 2016;88:112-5.
