Role of Transthoracic Ultrasound in Detection of Pneumonia in ICU Patients

Background: X-ray is widely recognized as a crucial step in the diagnosis of pneumonia. The limitations of chest X-ray in the diagnosis of pneumonia are more evident in some sites of care such as the ICU or emergency department. Aim of the Work: The aim of this work is to study the role of transthoracic ultrasound in diagnosis and follow-up of pneumonia in ICU patients. Subjects and Methods: This study was conducted on 38 RICU patients in Bab El-Sha eria University Hospital suspected of pneumonia by history and physical examination, after recording a written consent at the period from November 2013 to May 2014. All patients undergone: Complete history taking, general and local chest examination, laboratory inves-tigation including. CBC, ESR, renal and hepatic profile, CURB-65 score assessment, plain chest radiography, Computerized tomography (CT) chest scan and transthoracic ultrasound was done for all patients. On clinical suspicion of pneumonia, transthoracic ultrasonography was done, then chest radiography was carried out and CT chest was done for all patients (38 patients) as a gold standard test. Then patients was classified into two groups: Confirmed pneumonia group, patients with positive CT finding for pneumonia (30 patients) and confirmed non pneumonia group, patients with negative CT findings for pneumonia (8 patients with other diagnosis). Results: The sensitivity and specificity of transthoracic ultrasound in diagnosing pneumonia in ICU when compared with CT chest were 93.33% and 75.0% respectively. While the sensitivity and specificity of chest X-ray in diagnosing pneumonia in ICU when compared with CT chest were 80.0% and 62.5% respectively. Conclusion: Transthoracic ultrasound has a valuable role in the diagnosis and follow-up of pneumonia in ICU patients, as it is a bedside real-time, reliable, rapid and noninvasive technique. Recommendation: Pneumonia in ICU could be diagnosed and followed-up by transthoracic ultrasound.