Lung Ultrasound Versus Chest X-ray in Children Admitted to Paediatric Intensive Care Unit at Al-Zahraa University Hospital

Background: Lung ultrasound (LUS) has emerged as a promising, radiation-free bedside imaging instrument for assessing pulmonary conditions in children.Aim of the work: This study aimed to compare the accuracy of point-of-care lung US and routine bedside CXR in diagnosis of different pulmonary disorders in PICU at Al-Zahraa University Hospital. Methods: This cross-sectional study was conducted from December 2023 to May 2024, including 100 pediatric patients requiring CXR upon PICU admission. LUS was performed within 24 hours using a standardized six-zone protocol, and both imaging modalities were evaluated blindly. Results: LUS detected significantly more cases of pleural effusion (59% vs. 26%, p<0.001) and empyema (9% versus 2%, p=0.029) than CXR. The percentage of patients with multiple findings was also higher on LUS (p<0.001). LUS showed 100% sensitivity across all assessed conditions, with high specificity and accuracy, particularly for consolidation (specificity 87.8%, accuracy 94%) and empyema (specificity 92.9%, accuracy 93%). Additionally, patients with positive CXR findings had significantly higher WBC and CRP levels (p=0.001 and 0.002, correspondingly). Conclusion: LUS proved to be a reliable, non-invasive diagnostic tool, often superior to CXR in identifying pediatric pulmonary disorders. Its real-time imaging, absence of radiation, and high diagnostic accuracy support its routine use in PICU settings