NDLI: Bedside lung ultrasound for the diagnosis of pneumonia in children presenting to an emergency department in a resource-limited setting

Content Provider	Springer Nature : BioMed Central
Author	Amatya, Yogendra Russell, Frances M. Rijal, Suraj Adhikari, Sunil Nti, Benjamin House, Darlene R.
Abstract	Background Lung ultrasound (LUS) is an effective tool for diagnosing pneumonia; however, this has not been well studied in resource-limited settings where pneumonia is the leading cause of death in children under 5 years of age. Objective The objective of this study was to evaluate the diagnostic accuracy of bedside LUS for diagnosis of pneumonia in children presenting to an emergency department (ED) in a resource-limited setting. Methods This was a prospective cross-sectional study of children presenting to an ED with respiratory complaints conducted in Nepal. We included all children under 5 years of age with cough, fever, or difficulty breathing who received a chest radiograph. A bedside LUS was performed and interpreted by the treating clinician on all children prior to chest radiograph. The criterion standard was radiographic pneumonia, diagnosed by a panel of radiologists using the Chest Radiography in Epidemiological Studies methodology. The primary outcome was sensitivity and specificity of LUS for the diagnosis of pneumonia. All LUS images were later reviewed and interpreted by a blinded expert sonographer. Results Three hundred and sixty-six children were enrolled in the study. The median age was 16.5 months (IQR 22) and 57.3% were male. Eighty-four patients (23%) were diagnosed with pneumonia by chest X-ray. Sensitivity, specificity, positive and negative likelihood ratios for clinician’s LUS interpretation was 89.3% (95% CI 81–95), 86.1% (95%CI 82–90), 6.4, and 0.12 respectively. LUS demonstrated good diagnostic accuracy for pneumonia with an area under the curve of 0.88 (95% CI 0.83–0.92). Interrater agreement between clinician and expert ultrasound interpretation was excellent (k = 0.85). Conclusion Bedside LUS when used by ED clinicians had good accuracy for diagnosis of pneumonia in children in a resource-limited setting.
Related Links	https://intjem.biomedcentral.com/counter/pdf/10.1186/s12245-022-00474-w.pdf
Ending Page	5
Page Count	5
Starting Page	1
File Format	HTM / HTML
ISSN	18651380
DOI	10.1186/s12245-022-00474-w
Journal	International Journal of Emergency Medicine
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2023-01-09
Access Restriction	Open
Subject Keyword	Emergency Medicine Internal Medicine Cardiology Angiology Pediatrics Lung ultrasound Pneumonia Diagnosis Developing countries Pediatric
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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