Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?

Objective. To compare lung ultrasound (LUS) with auscultation findings in children with clinical suspicion of pneumonia. Patients and methods. A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y) with referral diagnosis of suspected pneumonia. In al...

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Main Authors: Jovan Lovrenski, Slobodanka Petrović, Svetlana Balj-Barbir, Radoica Jokić, Gordana Vilotijević-Dautović
Format: Article
Language:English
Published: Academy of Sciences and Arts of Bosnia and Herzegovina 2016-05-01
Series:Acta Medica Academica
Subjects:
Online Access:http://ama.ba/index.php/ama/article/view/270/pdf
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author Jovan Lovrenski
Slobodanka Petrović
Svetlana Balj-Barbir
Radoica Jokić
Gordana Vilotijević-Dautović
author_facet Jovan Lovrenski
Slobodanka Petrović
Svetlana Balj-Barbir
Radoica Jokić
Gordana Vilotijević-Dautović
author_sort Jovan Lovrenski
collection DOAJ
description Objective. To compare lung ultrasound (LUS) with auscultation findings in children with clinical suspicion of pneumonia. Patients and methods. A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y) with referral diagnosis of suspected pneumonia. In all patients LUS and auscultatory examinations were performed within an hour. These findings were compared separately in each hemithorax. The radiologist performing LUS was blinded to the patient’s clinical information. Positive auscultatory findings included: crackles and/or abnormal breath sounds (decreased, asymmetric, absent, or bronchial). For LUS examinations a combined transthoracic – transabdominal approach was used. A pneumonia-positive LUS finding included subpleural consolidation with air-bronchogram, or an adjacent area of interstitial edema. For each subpleural consolidation the cranio-caudal (CC) diameter was measured, and 95% confidence intervals (CI) of the sizes of subpleural consolidations for positive and negative auscultatory findings were compared. The p-value between LUS and auscultation was calculated using McNemar’s test. Results. LUS and auscultation showed pneumonia-positive findings in 98 and 64 hemithoraces, i.e. in 67 and 45 patients respectively. In positive auscultatory findings the CI for CC diameters of subpleural consolidations ranged from 32.46 to 54.14 mm, and in negative auscultatory findings the CI was between 16.52 and 29.83 mm, which showed a statistically significant difference. McNemar’s test showed a statistically significant difference between LUS and auscultation. Conclusions. LUS showed positive findings in more hemithoraces than auscultation in children with suspected pneumonia. A cranio-caudal size of subpleural consolidation of less than 30 mm significantly reduces the possibility of auscultatory detection.
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spelling doaj.art-01dd77a8a8504ab5b83f41a2f6a31a382022-12-22T03:17:25ZengAcademy of Sciences and Arts of Bosnia and HerzegovinaActa Medica Academica1840-18481840-28792016-05-01451395010.5644/ama2006-124.155Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?Jovan Lovrenski0Slobodanka Petrović1Svetlana Balj-Barbir2Radoica Jokić3Gordana Vilotijević-Dautović4Radiology Department, Institute for Children and Adolescents Health Care of Vojvodina, Serbia.Pulmonology Department, Institute for Children and Adolescents Health Care of Vojvodina, Serbia.Radiology Department, Institute for Children and Adolescents Health Care of Vojvodina, Serbia.Pediatric Surgery Department, Institute for Children and Adolescents Health Care of Vojvodina, Serbia.Pulmonology Department, Institute for Children and Adolescents Health Care of Vojvodina, Serbia.Objective. To compare lung ultrasound (LUS) with auscultation findings in children with clinical suspicion of pneumonia. Patients and methods. A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y) with referral diagnosis of suspected pneumonia. In all patients LUS and auscultatory examinations were performed within an hour. These findings were compared separately in each hemithorax. The radiologist performing LUS was blinded to the patient’s clinical information. Positive auscultatory findings included: crackles and/or abnormal breath sounds (decreased, asymmetric, absent, or bronchial). For LUS examinations a combined transthoracic – transabdominal approach was used. A pneumonia-positive LUS finding included subpleural consolidation with air-bronchogram, or an adjacent area of interstitial edema. For each subpleural consolidation the cranio-caudal (CC) diameter was measured, and 95% confidence intervals (CI) of the sizes of subpleural consolidations for positive and negative auscultatory findings were compared. The p-value between LUS and auscultation was calculated using McNemar’s test. Results. LUS and auscultation showed pneumonia-positive findings in 98 and 64 hemithoraces, i.e. in 67 and 45 patients respectively. In positive auscultatory findings the CI for CC diameters of subpleural consolidations ranged from 32.46 to 54.14 mm, and in negative auscultatory findings the CI was between 16.52 and 29.83 mm, which showed a statistically significant difference. McNemar’s test showed a statistically significant difference between LUS and auscultation. Conclusions. LUS showed positive findings in more hemithoraces than auscultation in children with suspected pneumonia. A cranio-caudal size of subpleural consolidation of less than 30 mm significantly reduces the possibility of auscultatory detection.http://ama.ba/index.php/ama/article/view/270/pdfPneumoniaChildrenUltrasoundAuscultation
spellingShingle Jovan Lovrenski
Slobodanka Petrović
Svetlana Balj-Barbir
Radoica Jokić
Gordana Vilotijević-Dautović
Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?
Acta Medica Academica
Pneumonia
Children
Ultrasound
Auscultation
title Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?
title_full Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?
title_fullStr Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?
title_full_unstemmed Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?
title_short Stethoscope vs. ultrasound probe - which is more reliable in children with suspected pneumonia?
title_sort stethoscope vs ultrasound probe which is more reliable in children with suspected pneumonia
topic Pneumonia
Children
Ultrasound
Auscultation
url http://ama.ba/index.php/ama/article/view/270/pdf
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