Diagnostic Accuracy of Lung Ultrasound for Pneumonia in Adult Intensive Care Unit Patients: A Systematic Review and...

This systematic review and meta-analysis were conducted in an effort to evaluate the accuracy of using lung ultrasound (LUS) in the diagnosis of pneumonia in adult patients who are admitted to the intensive care unit (ICU) compared to the standard of care. The search involved obtaining data through the Medical Literature Analysis and Retrieval System Online (MEDLINE), PubMed, ClinicalTrials.gov, and Google Scholar and was conducted from inception until May 2026 to identify eligible studies. We included adult patients admitted to the ICU who were diagnosed with pneumonia on admission or developed pneumonia while in the ICU as hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP). Those patients were evaluated by bedside LUS for the diagnosis of pneumonia, and their results were compared to the standard of care.  A total of 2,704 articles were identified. Six studies were included in this systematic review and meta-analysis, presenting a total of 518 patients enrolled and 275 patients diagnosed with pneumonia using the standard of care, which included chest X-ray (CXR), CT scan of the chest, laboratory and culture data, biomarkers, or clinical diagnosis by the provider. The mean age was 63.9 years. 71.2% of patients were male, and 28.8% were female. The estimated summary measures of sensitivity (SE) and specificity (SP) of LUS were calculated as 0.95 (95% CI: 0.88, 0.98, p<0.01) and 0.71 (95% CI: 0.60, 0.80, p<0.01), respectively. Heterogeneity was moderate for both SE (I2=32.68, 2=0.38) and SP (I2=13.17, 2=0.15). The LUS application in the ICU has a high SE and moderate SP in the diagnosis of pneumonia in adult patients compared to the standard of care. Larger cohorts and data collection with analysis are needed to further understand and optimize protocols for LUS in the ICU to better inform the management of patients with pneumonia.