Chest sonography versus chest radiograph in children admitted to paediatric intensive care - A prospective study

Area of Science:

• Pediatric critical care medicine
• Diagnostic imaging
• Pulmonary medicine

Background:

• Limited research exists on the correlation between chest radiography and ultrasound in pediatric patients.
• Accurate and timely diagnosis of thoracic conditions in critically ill children is crucial.

Purpose of the Study:

• To investigate the correlation between bedside chest radiography and ultrasound findings in a pediatric intensive care unit.
• To compare the diagnostic sensitivity of chest ultrasound versus chest radiography for specific thoracic conditions.

Main Methods:

• Prospective, double-blinded observational study involving 413 children and 1002 paired chest radiograph and ultrasound examinations.
• Weighted kappa statistic was used to assess agreement between imaging modalities.
• Analysis focused on the detection of pulmonary edema, pneumothorax, and pleural effusion.

Main Results:

• Agreement between chest radiography and ultrasound varied by lung and condition, ranging from 50% for left pleural effusion to 98% for right pneumothorax.
• Ultrasound alone diagnosed pulmonary edema, pneumothorax, and pleural effusion in a significantly higher number of patients compared to chest radiography (P=0.001).

Conclusions:

• Chest ultrasound demonstrates superior sensitivity compared to chest radiography in detecting pleural effusion, pulmonary edema, and pneumothorax in children.
• Bedside chest ultrasound is a valuable and more sensitive tool for diagnosing common thoracic pathologies in pediatric intensive care settings.