P0412 / #1173: POINT OF CARE ULTRASOUND OF THE LUNGS FOR DIAGNOSING RESPIRATORY PATHOLOGIES IN A PEDIATRIC INTENSIVE CARE UNIT

Abstract

Aims & Objectives: To determine the sensitivity and specificity of LUS in detecting lung pathology as compared to chest X-ray in patients admitted in PICU Methods: (LUS) examination of all children (1 month – 18 years) admitted in PICU who required respiratory support (invasive/ noninvasive) was compared with chest xray (CXR) of same day. LUS was done by a trained sonographer and read by sonographer and a PICU attending physician. CXR was read by a radiologist and PICU attending. Each LUS was taken independently for comparison to CXR. Sensitivity, specificity positive predictive value, and negative predictive value of chest X ray or ultrasound for the diagnosis of pulmonary pathologies were calculated. Kappa statistics was used to test agreement between different methods. Results: Total 220 LUS examinations were performed on 120 patients. Mean patients’ age was 39.71 ± 58.67 months and 51% were 1 years of age. Diagnosis included respiratory diseases in 67% patients, cardiovascular diseases in 23% and rest had miscellaneous conditions. 52% patients were on invasive respiratory support. LUS was completely performed in 195 (88.6%) of the times. Overall agreement for CXR interpretation between radiologist and intensivist was 0.95 (0.93 – 0.98) and for LUS between operator and interpreter was 0.86 (0.84 – 0.91). Sensitivity and specificity of the LUS to detect pulmonary pathology was 89.95% and 19% respectively. Sensitivity was highest in age <1 years and for diagnosis of pneumonia Conclusions: LUS is a very sensitive but not specific tool to identify lung abnormalities