RT Journal Article
SR Electronic
T1 Diagnostic imaging of parapneumonic effusion in children: Radiography versus sonography
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 379
VO 42
IS Suppl 57
A1 Mattia Guerra
A1 Giovanni Crichiutti
A1 Anna Pusiol
A1 Angelo Rosolen
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/379.abstract
AB Although lung ultrasound (LUS) has shown high diagnostic accuracy in detecting pleural fluid collections, its role in the work-up of parapneumonic effusion in children is not well established. LUS should be used to confirm the presence of a pleural effusion (evidence level III or IV) or to guide thoracocentesis and drain placement.[1]Aim To assess the reliability of chest X-ray (CXR) versus LUS to detect parapneumonic effusion in a paediatric emergency room (ER); to determine the prevalence of pleural effusion in moderate to severe community acquired pneumonia (CAP).Methods In this 4-year retrospective study inclusion criteria were: age (2-16years), evidence of CAP on CXR, a clinical severity assessment at first ER evaluation consistent with moderate to severe disease[2], CXR in standing position and bedside LUS at the time of ER admission.Results A total of 172 moderate to severe CAP cases were enrolled (mean age 5±2.9). In 105 (61%) cases a double view CXR was performed. A pleural effusion at ER presentation was identified by LUS in 63/172 cases. Only 35 effusions were shown by CXR, eight of which not confirmed by LUS. Sensitivity and specificity of CXR in upright position compared to LUS in detecting pleural effusion was 43% and 92%, respectively.Conclusions Bedside LUS could be adopted by the clinician as a reliable tool in the management of pleural infection. In paediatric age up to 36 % of moderate to severe CAP revealed an associated pleural effusion, although in most cases represented by small amount of anechoic fluid collection (exudative stage).[1]Balfour-Lynn IM et al. Thorax 2005;60:1-21[2]Harris M et al. Thorax 2011;66:1-23.