According to research from the Icahn School of Medicine, a lung ultrasound may be a better first step in diagnosing pediatric pneumonia than a chest X-ray. The lung ultrasound does not expose the patient to harmful radiation, costs less than a chest X-ray, and may be as accurate. Researchers looked at 191 patients ranging from newborns to 21-year-olds who came to their facility with symptoms of pneumonia requiring imaging for diagnosis. The patients were divided into two groups.
One group consisted of an investigational group of 103 who received lung ultrasound immediately and, if uncertainty remained, a chest X-ray could be done. The other 88 were the control arm, in which all patients had a chest X-ray followed by a lung ultrasound. A DotMed news report notes that only 63 of the 103 patients in the investigational group ended up needing follow-up X-ray imaging, which resulted in a 40% reduction.
Also, the research team reported no pneumonia cases were missed and no adverse effects were reported from the sonograms.
The researchers write, “The reduction in chest X-ray utilization in the investigational arm resulted in a cost reduction of $9,620 overall. Median ED length of stay was decreased by 26 minutes for subjects in the investigational arm compared to the control arm by intent to treat analysis.” In addition, they also reported an average charge for chest X-ray at $370 versus $140 for point-of-care ultrasound.
Sonographer experience was a factor as well, and usage dipped 30% in sonographers who were inexperienced versus a 60.6% drop among experienced sonographers.
In a meta-analysis of prior studies on the same topic, the DotMed news report notes that another group of researchers have found similar benefits with ultrasound for pediatric pneumonia and range of accuracy impacted by sonographer experience. The researchers determined that pneumonia was accurately identified in pediatric patients 96% of the time, with more experienced sonographers having the most success.