Community-Acquired Pneumonia Diagnosis Using Lung Ultrasound in Emergency Room Adults

Author(s):  
BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042547
Author(s):  
Atif Riaz ◽  
Olga Cambaco ◽  
Laura Elizabeth Ellington ◽  
Jennifer L Lenahan ◽  
Khatia Munguambe ◽  
...  

ObjectivesPaediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.DesignProspective qualitative study using semistructured interviewsSettingTwo referral hospitals in Mozambique and PakistanParticipantsA total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.ResultsHCPs highlighted themes of limited resource availability for the feasibility of LUS implementation, including perceived high cost of equipment, maintenance demands, time constraints and limited trained staff. HCPs emphasised the importance of policymaker support and caregiver acceptance for long-term success. HCP perspectives of usability highlighted ease of use and integration into existing workflow. HCPs and caregivers had positive attitudes towards LUS with few exceptions. Both HCPs and caregivers emphasised the potential for rapid, improved diagnosis of paediatric respiratory conditions using LUS.ConclusionsThis was the first study to evaluate HCP and caregiver perspectives of paediatric LUS through qualitative analysis. Critical components impacting feasibility, usability and acceptability of LUS for paediatric pneumonia diagnosis in LMIC were identified for initial deployment. Future research should explore LUS sustainability, with a particular focus on quality control, device maintenance and functionality and adoption of the new technology within the health system. This study highlights the need to engage both users and recipients of new technology early in order to adapt future interventions to the local context for successful implementation.Trial registration numberNCT03187067.


2020 ◽  
Vol 8 (1) ◽  
pp. 50-50
Author(s):  
Seyed Hossein Ojaghi Haghighi ◽  
Neda Hamed ◽  
Shiva Ebrahimi ◽  
Jafar Ghobadi ◽  
Hoorolnesa Ameli

Introduction: Congestive heart failure is heart muscle failure that causes pulmonary congestion and eventually pulmonary edema, which despite recent medical advances, is still a progressive syndrome with high mortality, the prevalence of which has increased in recent decades. Therefore, in this study we compared lung ultrasound findings in acute heart failure patients with the BNP. Methods: This study was performed in the emergency room of Imam Reza hospital in Tabriz. For patients entering the emergency room after taking a history, both standard gold (BNP) tests and beside ultrasound of the lung were performed. Ultrasound was performed at the same time as obtaining blood sample to ensure that the ultrasound specialist did not know the result of diagnosis. During the ultrasound, if there were multiple B-Lines that were at least 3 mm apart, patient was diagnosed with pulmonary edema due to heart failure. Results: Number of participants in this study was 108 people, 54.6% of whom were men and the rest were women. The correlation coefficient between width and number of kerley lines was 0.79, between NT-pro BNP and width of kerley lines was 0.65 and between NT-pro BNP and number of kerley lines was 0.77, which indicates a significant positive correlation (P value <0.001). Conclusion: The results of present study showed that in patients with acute heart failure, the number and width of kerley lines in pulmonary ultrasound evaluation increase rapidly. There is also a high correlation between number and length of kerley lines with NT-pro BNP serum values.


Author(s):  
Muhammad Ahmad Syammakh ◽  
Elim Jusri ◽  
Gede Agung Setya ◽  
Made Aryadi Sukartika

Pneumonia is most common cause of respiratory distress an infection of the pulmonary parenchyma. Despite being the cause of significant morbidity and mortality, it is often misdiagnosed, mistreated, and underestimated. Pneumonia historically was Typically classified as community-acquired (CAP), hospital-acquired (HAP), or ventilator-associated (VAP). A 68-year-old male was sent to the emergency department from clinic with an oxygen saturation of 86%. She has fevers with cough and generalized weakness for one week. She had been evaluated by her primary care provider on day two of illness and was started empirically on cefixime without improvement of her symptoms. The patient arrived febrile, tachycardic, tachypneic, and hypoxic on room air with right-sided crackles on exam. Lung Ultrasound of the right lower lobe demonstrates lung hepatization, a classic finding for pneumonia. In addition, a shred sign is present with both air bronchograms and focal B lines-all suggestive of poorly aerated, consolidated lung. Authors critically evaluate the evidence for the use lung ultrasound for rapid diagnostic. It is important to understand this disease, rapid diagnostic with ultrasound and when treated promptly and effectively, these patients will rapidly recovery. Good oxygenation, intravenous Antibiotic, intravenous fluids and symptomatic treatment which should be started within minutes of the patients’ arrival to emergency department.


2019 ◽  
Vol 54 (9) ◽  
pp. 1479-1486 ◽  
Author(s):  
Anna Maria Musolino ◽  
Paolo Tomà ◽  
Maria Chiara Supino ◽  
Barbara Scialanga ◽  
Alessia Mesturino ◽  
...  

Anaesthesia ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1620-1625 ◽  
Author(s):  
S. Bar ◽  
A. Lecourtois ◽  
M. Diouf ◽  
E. Goldberg ◽  
C. Bourbon ◽  
...  

2018 ◽  
Vol 12 (7) ◽  
pp. 2204-2211 ◽  
Author(s):  
Ahmed Omran ◽  
Samah Eesai ◽  
Mostafa Ibrahim ◽  
Sonya El-Sharkawy

2012 ◽  
Vol 102 (1) ◽  
pp. 6-7 ◽  
Author(s):  
Massimiliano Don ◽  
Alfredo Barillari ◽  
Luigi Cattarossi ◽  
Roberto Copetti ◽  

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