Evaluation of lung ultrasound for the diagnosis of pneumonia in the ED.
OBJECTIVE
The aim of this study is to assess the ability of bedside lung ultrasound (US) to confirm clinical suspicion of pneumonia and the feasibility of its integration in common emergency department (ED) clinical practice.


METHODS
In this study we performed lung US in adult patients admitted in our ED with a suspected pneumonia. Subsequently, a chest radiograph (CXR) was carried out for each patient. A thoracic computed tomographic (CT) scan was made in patients with a positive lung US and a negative CXR. In patients with confirmed pneumonia, we performed a follow-up after 10 days to evaluate clinical conditions after antibiotic therapy.


RESULTS
We studied 49 patients: pneumonia was confirmed in 32 cases (65.3%). In this group we had 31 (96.9%) positive lung US and 24 (75%) positive CXR. In 8 (25%) cases, lung US was positive with a negative CXR. In this group, CT scan always confirmed the US results. In one case, US was negative and CXR positive. Follow-up turned out to be always consistent with the diagnosis.


CONCLUSIONS
Considering that lung US is a bedside, reliable, rapid, and noninvasive technique, these results suggest it could have a significant role in the diagnostic workup of pneumonia in the ED, even if no sensitivity nor specificity can be inferred from this study because the real gold standard is CT, which could not be performed in all patients.
Parlamento
Stefano
S
Emergency Department, S. Antonio Abate Hospital, 33028 Tolmezzo, Italy. palamuto@gmail.com
Copetti
Roberto
R
Di Bartolomeo
Stefano
S
D000328:Adult; D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000000981:diagnostic imaging*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography