Utility of Point-of-Care Lung Ultrasonography for Evaluating Acute Chest Syndrome in Young Patients With Sickle Cell Disease

Point‐of‐care lung ultrasound is more reliable than chest X‐ray for ruling out acute chest syndrome in sickle cell pediatric patients: A prospective study

“…29 Copetti and Cattarossi 23 Previous studies have also reported on the accuracy of point-of-care LUS for detecting ACS consolidations. [30][31][32][33][34] In a study by Colla et al, 34 the potential role of point-of-care LUS for early recognition of ACS was observed. Twenty adults with SCD who presented to the ED with pain crises were evaluated using point-ofcare LUS to detect early findings of ACS.…”

“…To our knowledge, there are only two published studies that explored the accuracy of LUS for diagnosing consolidations in sickle cell children with suspected ACS. 30,32 Daswani et al 32 evaluated 91 children with SCD who presented with fever in a total of 116 febrile events and found that a positive LUS had a sensitivity of 87% (95% CI: 62%-96%) and specificity of 94% (95% CI: 88%-97%) compared to CXR for detecting lung consolidations. In the recently published study by Cohen et al, 30 191 SCD patients from 0 to 21 years with suspected ACS in the ED were prospectively evaluated by novice sonographers, with study sensitivity and specificity of 81% and 91%, respectively, that improved to 88% and 93%, respectively, when a blinded expert review of ultrasound images was considered.…”

“…In both above-mentioned studies, 30,32 the sonographers were blinded to the patient's clinical history and physical examination information. Unlike their groups, in our study, all the sonographers were aware of the patient's clinical information.…”

“…As LUS is an operator-dependent diagnostic tool, the level of experience of the sonographers plays an important role on the test accuracy. Cohen et al 30 observed that six out of their 11 "false-positive" cases and three out of their four "false-negative" cases were due to novice sonographers' error. Later review of the "false-negative" cases showed that three of them had less than 1-cm consolidations and ultimately received a diagnosis of ACS according to follow-up radiography.…”

“…Previous studies have also reported on the accuracy of point‐of‐care LUS for detecting ACS consolidations 30–34 …”