Role of Lung Ultrasound in Detection of Respiratory Diseases in Paediatric Intensive Care Unit

Background: Lung ultrasonography, a radiation-free substitute for chest X-rays, offers real-time imaging capabilities and helps address the diagnostic issues associated with pediatric respiratory disorders in the critical care unit. Objective: This study's main goal was to assess how well lung ultrasonography diagnoses and uses clinical lung ultrasonography to identify respiratory disorders in pediatric patients admitted to the critical care unit. Methodology: Pediatric patients aged 1 to 12 who were hospitalized to the Pediatric Intensive Care Unit (PICU) were the subjects of this prospective observational research, which was carried out at the Pakistan Institute of Medical Sciences (PIMS) in Islamabad, Pakistan, over the course of a year, from January to December 2023. Individuals who had confusing lung pathologies or were contraindicated for ultrasonography were eliminated, whereas those with respiratory disorders such as pneumonia, bronchiolitis, asthma exacerbation, or respiratory distress syndrome were included. Clinical data, including demographics, symptoms, medical history, and radiological results, were gathered from 240 individuals in the sample. Trained sonographers conducted lung ultrasonography exams according to a set methodology that prioritized anatomical landmarks. Lung ultrasonography's diagnostic accuracy was evaluated using statistical analysis, which included sensitivity, specificity, and predictive values. Results: The most common respiratory ailment, accounting for 86 out of 240 cases (35.83%), was pneumonia. When compared to chest X-rays, lung ultrasonography demonstrated greater sensitivity (79.28%) and specificity (56.19%). Pneumonia patients showed much higher good ultrasonography results (p=0.001). Hospital stays for lung ultrasonography were 6.82 days, whereas those for chest X-rays were 9.15 days (p=0.021). Furthermore, the most prevalent respiratory diagnoses were asthma (22.50%) and bronchiolitis (25.83%). 163 individuals had good results from lung ultrasonography, while 112 patients had positive results from chest X-rays. Lung ultrasonography has a 62.50% positive predictive value and a 73.91% negative predictive value. Conclusion: Lung ultrasound demonstrates promise as a diagnostic tool for pediatric respiratory diseases in PICUs, with superior sensitivity, shorter hospital stays, and significant utility in pneumonia detection.