Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalization

Background: In childhood pneumonia, pediatric lung ultrasound (PLUS) is a very sensitive and specific diagnostic alternative to chest X-ray (CXR). However, there is a paucity of literature on this in India. We set out to compare the diagnostic accuracy of PLUS and CXR in hospitalized children with c...

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Main Authors: Neetu Talwar, Lucky Manik, Krishan Chugh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Lung India
Subjects:
Online Access:http://www.lungindia.com/article.asp?issn=0970-2113;year=2022;volume=39;issue=3;spage=267;epage=273;aulast=Talwar
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author Neetu Talwar
Lucky Manik
Krishan Chugh
author_facet Neetu Talwar
Lucky Manik
Krishan Chugh
author_sort Neetu Talwar
collection DOAJ
description Background: In childhood pneumonia, pediatric lung ultrasound (PLUS) is a very sensitive and specific diagnostic alternative to chest X-ray (CXR). However, there is a paucity of literature on this in India. We set out to compare the diagnostic accuracy of PLUS and CXR in hospitalized children with community-acquired pneumonia (CAP). Setting and Design: Prospective, observational study (June 2017–September 2019) at a tertiary care hospital. Methods: Hospitalized children of CAP (3 months–18 years) were included after taking informed, written consent. Hemodynamic instability, asthma, cystic fibrosis, congenital heart disease, immunodeficiency, and malignancy cases were excluded. CXR (frontal view) and PLUS were done within 6 h of each other and within 24 h of hospitalization. Statistical analysis was performed using SPSS software version 25. Results: Out of 612 consecutive, hospitalized respiratory cases, 261 were recruited. CAP was diagnosed clinically in 148 (56.7%) patients [95 boys (64.19%), mean age in years ± SD: 4.31 ± 4.41]. Abnormal PLUS was present in 141 (95.27%) and abnormal CXR in 128 (86.48%) patients. In radiologically diagnosed pneumonia, PLUS was detected in 123 [123/128 (96.09%)] children, and when CXR was normal, PLUS was abnormal in 18 [18/20 (90%)]. PLUS showed a sensitivity of 95.27% (95%CI: 90.50–98.08) and a specificity of 92.90% (95%CI: 86.53–96.89). CXR showed a sensitivity of 86.49% (95%CI: 79.9–91.55) and a specificity of 90.27% (95%CI: 83.25–95.04). Conclusions: PLUS is a sensitive, specific test and can be considered as the preferred investigation before CXR in children hospitalized with CAP.
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spelling doaj.art-46978d0106174ebd9eb27d0bd5df99d32022-12-22T01:09:58ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2022-01-0139326727310.4103/lungindia.lungindia_284_21Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalizationNeetu TalwarLucky ManikKrishan ChughBackground: In childhood pneumonia, pediatric lung ultrasound (PLUS) is a very sensitive and specific diagnostic alternative to chest X-ray (CXR). However, there is a paucity of literature on this in India. We set out to compare the diagnostic accuracy of PLUS and CXR in hospitalized children with community-acquired pneumonia (CAP). Setting and Design: Prospective, observational study (June 2017–September 2019) at a tertiary care hospital. Methods: Hospitalized children of CAP (3 months–18 years) were included after taking informed, written consent. Hemodynamic instability, asthma, cystic fibrosis, congenital heart disease, immunodeficiency, and malignancy cases were excluded. CXR (frontal view) and PLUS were done within 6 h of each other and within 24 h of hospitalization. Statistical analysis was performed using SPSS software version 25. Results: Out of 612 consecutive, hospitalized respiratory cases, 261 were recruited. CAP was diagnosed clinically in 148 (56.7%) patients [95 boys (64.19%), mean age in years ± SD: 4.31 ± 4.41]. Abnormal PLUS was present in 141 (95.27%) and abnormal CXR in 128 (86.48%) patients. In radiologically diagnosed pneumonia, PLUS was detected in 123 [123/128 (96.09%)] children, and when CXR was normal, PLUS was abnormal in 18 [18/20 (90%)]. PLUS showed a sensitivity of 95.27% (95%CI: 90.50–98.08) and a specificity of 92.90% (95%CI: 86.53–96.89). CXR showed a sensitivity of 86.49% (95%CI: 79.9–91.55) and a specificity of 90.27% (95%CI: 83.25–95.04). Conclusions: PLUS is a sensitive, specific test and can be considered as the preferred investigation before CXR in children hospitalized with CAP.http://www.lungindia.com/article.asp?issn=0970-2113;year=2022;volume=39;issue=3;spage=267;epage=273;aulast=Talwarchest x-raycommunity-acquired pneumoniahospitalizedlung ultrasound
spellingShingle Neetu Talwar
Lucky Manik
Krishan Chugh
Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalization
Lung India
chest x-ray
community-acquired pneumonia
hospitalized
lung ultrasound
title Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalization
title_full Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalization
title_fullStr Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalization
title_full_unstemmed Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalization
title_short Pediatric Lung Ultrasound (PLUS) in the diagnosis of Community-Acquired Pneumonia (CAP) requiring hospitalization
title_sort pediatric lung ultrasound plus in the diagnosis of community acquired pneumonia cap requiring hospitalization
topic chest x-ray
community-acquired pneumonia
hospitalized
lung ultrasound
url http://www.lungindia.com/article.asp?issn=0970-2113;year=2022;volume=39;issue=3;spage=267;epage=273;aulast=Talwar
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AT krishanchugh pediatriclungultrasoundplusinthediagnosisofcommunityacquiredpneumoniacaprequiringhospitalization