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Lung ultrasound for diagnosis of pneumonia in emergency department

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Abstract

Lung ultrasound (LUS) in the emergency department (ED) has shown a significant role in the diagnostic workup of pulmonary edema, pneumothorax and pleural effusions. The aim of this study is to assess the reliability of LUS for the diagnosis of acute pneumonia compared to chest X-ray (CXR) study. The study was conducted from September 2013 to March 2015. 107 patients were admitted to the ED with a clinical appearance of pneumonia. All the patients underwent a CXR study, read by a radiologist, and an LUS, performed by a trained ED physician on duty. Among the 105 patients, 68 were given a final diagnosis of pneumonia. We found a sensitivity of 0.985 and a specificity of 0.649 for LUS, and a sensitivity of 0.735 and specificity of 0.595 for CXR. The positive predictive value for LUS was 0.838 against 0.7 for CXR. The negative predictive value of LUS was 0.960 versus 0.550 for CXR. This study has shown sensitivity, positive predictive value and negative predictive value of LUS compared to the CXR study for the diagnosis of acute pneumonia. These results suggest the use of bedside thoracic US first-line diagnostic tool in patients with suspected pneumonia.

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Abbreviations

LUS:

Lung ultrasound

ED:

Emergency department

CXR:

Chest X-ray

COPD:

Chronic obstructive pulmonary disease

CHF:

Congestive heart failure

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Authors and Affiliations

  1. Emergency department, Cardarelli Hospital, Neaples, Italy

    Antonio Pagano, Giuseppe Visone, Marinella Olibet, Rodolfo Nasti & Fiorella Paladino

  2. Emergency department, San Paolo Hospital, Neaples, Italy

    Fabio Giuliano Numis, Concetta Pirozzi & Fernando Schiraldi

  3. Department of Medicine and Surgery, University of Salerno, Salerno, Italy

    Mario Masarone

Authors
  1. Antonio Pagano
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  2. Fabio Giuliano Numis
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  3. Giuseppe Visone
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  4. Concetta Pirozzi
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  5. Mario Masarone
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  6. Marinella Olibet
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  7. Rodolfo Nasti
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  8. Fernando Schiraldi
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  9. Fiorella Paladino
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Corresponding author

Correspondence to Antonio Pagano.

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Conflict of interest

The authors declare that they have no competing interests.

Statement of human and animal rights

The study was conducted in accordance to the principles of the declaration of Helsinky.

Informed consent

All patients gave their informed consent to ultrasound examination.

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Pagano, A., Numis, F.G., Visone, G. et al. Lung ultrasound for diagnosis of pneumonia in emergency department. Intern Emerg Med 10, 851–854 (2015). https://doi.org/10.1007/s11739-015-1297-2

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  • DOI: https://doi.org/10.1007/s11739-015-1297-2

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