Volume 6 Supplement 2

7th WINFOCUS Italian Congress on Ultrasound in Emergency, Anaesthesiology and Critical Care

Open Access

The role of lung ultrasound in the diagnosis of pneumonia in acutely ill patients

Critical Ultrasound Journal20146(Suppl 2):A2

DOI: 10.1186/2036-7902-6-S2-A2

Published: 27 August 2014

Background

The differential diagnosis of patients in the emergency department who show symptoms of sepsis and suspected pneumonia may be difficult because of the low sensitivity and specificity of supine chest X rays (SCXR) and physical examination.

Objective

A retrospective assessment of the usefulness of lung ultrasound (LU) in the diagnosis of pneumonia in patients with signs and symptoms of sepsis and respiratory disease.

Patients and methods

2 groups of patients were considered:

Group A: 22 patients with a positive first SCXR (SCXR1) for pneumonia

Group B: 18 patients with a negative SCXR1 for pneumonia, but who were subsequently diagnosed with pneumonia during their hospital stay following a second SCXR (SCXR2) or CT.

Lung ultrasound examination was performed within 24 hours of admission, searching for direct and indirect echographical signs of pneumonia: focal B lines (FBL), pleural effusion (PE) and images of lung consolidation (LC).

Results

See table 1.

Table 1

 

Group A (%)

Group B (%)

Male/Female

11/11

7/11

MEAN AGE

74,8

76,8

SCXR1 pos

22

0

SCXR2 or CT pos

-

18

FBL pos

9 (41)

10 (50)

FBL neg

13 (59)

10 (50)

PE pos

17 (78)

16 (80)

PE neg

5(22)

4 (20)

LC pos

19 (87)

20(100)

LC neg

3 (13)

0 (0)

LC pos or FBL pos

21 (95)

-

LU impact on therapy

No

20 (100)

Conclusions

In our observational study, LU showed high sensitivity in the diagnosis of pneumonia:

95% in patients already diagnosed using SCXR, and 100 % of early diagnosis of pneumonia in patients whose diagnosis was subsequently confirmed during hospitalization.

Authors’ Affiliations

(1)
Medicina 1 dept, Ospedale San Carlo Borromeo
(2)
Medicina d’ Urgenza, Ospedale San Carlo Borromeo

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Copyright

© Biancardi et al; licensee Springer 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.