The utility of chest x-ray and lung ultrasound in the management of infants and children presenting with severe pneumonia in low-and middle-income countries: A pragmatic scoping review

Kazi, Saniya; Hernstadt, Hayley; Abo, Yara-Natalie; Graham, Hamish; Palmer, M.; Graham, Stephen M.

doi:10.7189/jogh.12.10013

Cited by 4 publications

(1 citation statement)

References 88 publications

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“…Bedside lung ultrasound (LUS) is a noninvasive tool that can dynamically monitor lung changes in real time. Studies in low- and middle-income countries suggest that LUS may be useful in diagnosing and treating severe pneumonia in infants and children [ 3 ]. Another study indicated that novice and experienced sonographers could reduce chest X-ray usage by 30.0% and 60.6%, respectively, when using LUS, concluding that substituting LUS for chest X-ray in evaluating infants with suspected pneumonia is feasible and safe, without missing any pneumonia cases or increasing adverse event rates [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The correlation between lung ultrasound scores and outcomes of high-flow nasal cannula therapy in infants with severe pneumonia

Zheng,

Chen,

Zheng

et al. 2024

BMC Pediatr

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Objective The study aimed to explore the effectiveness of bedside lung ultrasound (LUS) combined with the PaO2/FiO2 (P/F) ratio in evaluating the outcomes of high-flow nasal cannula (HFNC) therapy in infants with severe pneumonia. Methods This retrospective study analyzed the clinical data of 150 infants diagnosed with severe pneumonia and treated with HFNC therapy at our hospital from January 2021 to December 2021. These patients were divided into two groups based on their treatment outcomes: the HFNC success group (n = 112) and the HFNC failure group (n = 38). LUS was utilized to evaluate the patients’ lung conditions, and blood gas results were recorded for both groups upon admission and after 12 h of HFNC therapy. Results At admission, no significant differences were observed between the two groups in terms of age, gender, respiratory rate, partial pressure of oxygen, and partial pressure of carbon dioxide. However, the P/F ratios at admission and after 12 h of HFNC therapy were significantly lower in the HFNC failure group (193.08 ± 49.14, 228.63 ± 80.17, respectively) compared to the HFNC success group (248.51 ± 64.44, 288.93 ± 57.17, respectively) (p < 0.05). Likewise, LUS scores at admission and after 12 h were significantly higher in the failure group (18.42 ± 5.3, 18.03 ± 5.36, respectively) than in the success group (15.09 ± 4.66, 10.71 ± 3.78, respectively) (p < 0.05). Notably, in the success group, both P/F ratios and LUS scores showed significant improvement after 12 h of HFNC therapy, a trend not observed in the failure group. Multivariate regression analysis indicated that lower P/F ratios and higher LUS scores at admission and after 12 h were predictive of a greater risk of HFNC failure. ROC analysis demonstrated that an LUS score > 20.5 at admission predicted HFNC therapy failure with an AUC of 0.695, a sensitivity of 44.7%, and a specificity of 91.1%. A LUS score > 15.5 after 12 h of HFNC therapy had an AUC of 0.874, with 65.8% sensitivity and 89.3% specificity. An admission P/F ratio < 225.5 predicted HFNC therapy failure with an AUC of 0.739, 60.7% sensitivity, and 71.1% specificity, while a P/F ratio < 256.5 after 12 h of HFNC therapy had an AUC of 0.811, 74.1% sensitivity, and 73.7% specificity. Conclusion Decreased LUS scores and increased P/F ratio demonstrate a strong correlation with successful HFNC treatment outcomes in infants with severe pneumonia. These findings may provide valuable support for clinicians in managing such cases.

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Section: Introductionmentioning

confidence: 99%

The correlation between lung ultrasound scores and outcomes of high-flow nasal cannula therapy in infants with severe pneumonia

Zheng,

Chen,

Zheng

et al. 2024

BMC Pediatr

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Pneumonia

Howie,

Hamer,

Langridge

et al. 2025

International Encyclopedia of Public Health

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Point of care lung ultrasonographic findings in patients with clinical diagnosis of severe childhood community acquired pneumonia in the tropics

Akinmoladun,

Atalabi,

Falade

et al. 2024

JPATS

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Objectives: This study aimed at defining the Lung ultrasonographic (LUS) features of severe Childhood community-acquired pneumonia (CAP) in under-5s with clinical pneumonia, as well as the correlation between clinical and ultrasonographic findings. Materials and Methods: A prospective descriptive study conducted at the Children Emergency Ward of the University College Hospital (UCH), Ibadan, Nigeria over a 1-year period. Children aged 1month to 59 months, with clinical features of severe pneumonia were recruited for the study. LUS was done at the bedside. Ethical approval was obtained for the study. Results: There were 86 children with mean age ± SD of 13.59 ± 15.55 and 50 (58.1%) males. The highest number of patients (56, 65.1%) were in the 1-12-month age group. Ultrasonographic signs of pneumonia were detected in 68 (79.1%) of the children; 55(64%) had consolidation, 29(23.3%) showed florid B-lines and 20 (23.3%) had pleural fluid. Duration of cough, and crackles on auscultation were the only features that showed significant association with the LUS diagnosis of pneumonia. Conclusion: LUS is a good point of care diagnosis of CAP in under-5 children and it can be safely done at the bedside. It is therefore recommended as a first line imaging modality in children with clinical suspicion of CAP in the Tropics.

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The utility of chest x-ray and lung ultrasound in the management of infants and children presenting with severe pneumonia in low-and middle-income countries: A pragmatic scoping review

Cited by 4 publications

References 88 publications

The correlation between lung ultrasound scores and outcomes of high-flow nasal cannula therapy in infants with severe pneumonia

The correlation between lung ultrasound scores and outcomes of high-flow nasal cannula therapy in infants with severe pneumonia

Pneumonia

Point of care lung ultrasonographic findings in patients with clinical diagnosis of severe childhood community acquired pneumonia in the tropics

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