Lung ultrasound patterns in paediatric pneumonia in Mozambique and Pakistan
| Autor: | Fyezah Jehan, Susanne May, Amy Sarah Ginsburg, Alessandro Lamorte, Carmen Munoz Almagro, Zunera Qasim, Benazir Balouch, M. Imran Nisar, Quique Bassat, Giovanni Volpicelli, Jun Hwang, Jennifer L Lenahan, Pio Vitorino, Marta Valente |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Imaging lcsh:Medicine 03 medical and health sciences 0302 clinical medicine Secondary analysis Internal medicine Medicine Integrated Management of Childhood Illness medicine.diagnostic_test business.industry lcsh:R 030208 emergency & critical care medicine Original Articles medicine.disease Lung ultrasound respiratory tract diseases Pneumonia Carriage 030228 respiratory system Cohort Observational study business Chest radiograph |
| Zdroj: | ERJ Open Research, Vol 7, Iss 1 (2021) ERJ Open Research article-version (VoR) Version of Record |
| ISSN: | 2312-0541 |
| Popis: | Objective Improved pneumonia diagnostics are needed, particularly in resource-constrained settings. Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing pneumonia. The objective was to explore LUS patterns associated with paediatric pneumonia. Methods We conducted a prospective, observational study among children aged 2 to 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at two district hospitals in Mozambique and Pakistan. We assessed LUS and chest radiograph (CXR) examinations, and viral and bacterial nasopharyngeal carriage, and performed a secondary analysis of LUS patterns. Results LUS demonstrated a range of distinctive patterns that differed between children with and without pneumonia and between children in Mozambique versus Pakistan. The presence of LUS consolidation or interstitial patterns was more common in children with chest-indrawing pneumonia than in those without pneumonia. Consolidations were also more common among those with only bacterial but no viral carriage detected (50.0%) than among those with both (13.0%) and those with only virus detected (8.3%; p=0.03). LUS showed high interrater reliability among expert LUS interpreters for overall determination of pneumonia (κ=0.915), consolidation (κ=0.915) and interstitial patterns (κ=0.901), but interrater reliability between LUS and CXR for detecting consolidations was poor (κ=0.159, Pakistan) to fair (κ=0.453, Mozambique). Discussion Pattern recognition was discordant between LUS and CXR imaging modalities. Further research is needed to define and standardise LUS patterns associated with paediatric pneumonia and to evaluate the potential value of LUS as a reference standard. This study explored distinctive lung ultrasound patterns associated with paediatric community-acquired pneumonia in Mozambique and Pakistan, and found reliable pattern recognition critical to identifying pneumonia https://bit.ly/3eWWvXr |
| Databáze: | OpenAIRE |
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