Lung ultrasounds may be a safe and effective replacement for chest X-rays when diagnosing pneumonia in children, according to researchers from the Icahn School of Medicine at Mount Sinai Hospital.
The study was led by James Tsung, MD, MPH, associate professor in the Department of Emergency Medicine and Department of Pediatrics at the Icahn School of Medicine at Mount Sinai Hospital.
“Ultrasound is portable, cost-saving, and safer for children than an X-ray because it does not expose them to radiation,” Dr Tsung explained in a prepared statement about the study. “Our study could have a profound impact in the developing world where access to radiography is limited.”
Researchers compared lung ultrasounds to chest X-rays in 191 children between 0 and 21 years of age from the pediatric emergency department at Mount Sinai Hospital. The patients were randomly assigned to either the investigational cohort, where patients received lung ultrasound and an additional chest X-ray if a physician required further verification, or the control cohort, where patients received a chest X-ray followed by a lung ultrasound.
There was a 38.8% reduction in chest X-rays in the investigational cohort with no missed pneumonia cases and no increases in adverse events. Reducing the number of X-rays in this group saved approximately $9200, and the length of stay in the emergency department was reduced by 26 minutes.
The results suggest that lung ultrasound has the potential to become the preferred method for diagnosing pneumonia in children, especially as more handheld ultrasound machines are being developed. Additional studies should focus on the effect of lung ultrasound on antibiotic use and stewardship, the researchers noted.
“In the era of precision medicine, lung ultrasound may also be an ideal imaging option in children who are at higher risk for radiation-induced cancers or have received multiple radiographic or CT imaging studies,” Dr Tsung concluded.
- Icahn School of Medicine at Mount Sinai. Lung ultrasound may be a safe substitute for chest x-ray when diagnosing pneumonia in children. Accessed May 10, 2016.