Trial reportEuropean journal of medical research2024
Lung ultrasound and procalcitonin, improving antibiotic management and avoiding radiation exposure in pediatric critical patients with bacterial pneumonia: a randomized clinical trial.
Trial report in European journal of medical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04217980 (Analysis of a Diagnostic Algorithm of Severe Pneumonia in Pediatric Critical Patients by Pulmonary Ultrasound and Procalcitonin as a Plan to Improve the Quality of Care), which is not on this map. Cited by 7 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Analysis of a Diagnostic Algorithm of Severe Pneumonia in Pediatric Critical Patients by Pulmonary Ultrasound and Procalcitonin as a Plan to Improve the Quality of Care
Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Lung ultrasound combined with C-reactive protein for identifying a bacterial component in children hospitalized with acute lower respiratory tract infections: a prospective observational study.European journal of pediatrics · 2026Observational
- Diagnostic testing and antibiotic stewardship for pneumonia in children worldwide: current developments and next steps.Current opinion in pediatrics · 2025Review
- Use of procalcitonin in therapeutic decisions in the pediatric intensive care unit.Annals of intensive care · 2025Review
- Lung Elastance and Microvascularization as Quantitative Non-Invasive Biomarkers for the Aetiological Diagnosis of Lung Consolidations in Children (ELASMIC Study).Diagnostics (Basel, Switzerland) · 2025Article
- Critical care ultrasound: development, evolution, current and evolving clinical concepts in critical care medicine.Frontiers in medicine · 2025Review
- Lung Ultrasound Efficacy in Monitoring Post-SARS-CoV-2 Pneumonia and Inflammatory Biomarkers in Pediatric Patients.Medicina (Kaunas, Lithuania) · 2024Observational
- Ventilator-Associated Pneumonia: An Update on the Role of Lung Ultrasound in Adult, Pediatric, and Neonatal ICU Practice.Therapeutic advances in pulmonary and critical care medicineReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumonia is a major public health problem with an impact on morbidity and mortality. Its management still represents a challenge. The aim was to determine whether a new diagnostic algorithm combining lung ultrasound (LUS) and procalcitonin (PCT) improved pneumonia management regarding antibiotic use, radiation exposure, and associated costs, in critically ill pediatric patients with suspected bacterial pneumonia (BP).
methodsRandomized, blinded, comparative effectiveness clinical trial. Children < 18y with suspected BP admitted to the PICU from September 2017 to December 2019, were included. PCT was determined at admission. Patients were randomized into the experimental group (EG) and control group (CG) if LUS or chest X-ray (CXR) were done as the first image test, respectively. Patients were classified: 1.LUS/CXR not suggestive of BP and PCT < 1 ng/mL, no antibiotics were recommended; 2.LUS/CXR suggestive of BP, regardless of the PCT value, antibiotics were recommended; 3.LUS/CXR not suggestive of BP and PCT > 1 ng/mL, antibiotics were recommended.
results194 children were enrolled, 113 (58.2%) females, median age of 134 (IQR 39-554) days. 96 randomized into EG and 98 into CG. 1. In 75/194 patients the image test was not suggestive of BP with PCT < 1 ng/ml; 29/52 in the EG and 11/23 in the CG did not receive antibiotics. 2. In 101 patients, the image was suggestive of BP; 34/34 in the EG and 57/67 in the CG received antibiotics. Statistically significant differences between groups were observed when PCT resulted < 1 ng/ml (p = 0.01). 3. In 18 patients the image test was not suggestive of BP but PCT resulted > 1 ng/ml, all of them received antibiotics. A total of 0.035 mSv radiation/patient was eluded. A reduction of 77% CXR/patient was observed. LUS did not significantly increase costs.
conclusionsCombination of LUS and PCT showed no risk of mistreating BP, avoided radiation and did not increase costs. The algorithm could be a reliable tool for improving pneumonia management. CLINICAL
trial registrationNCT04217980.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.