ArticleCritical care science2026
Diagnostic accuracy of lung ultrasound in children with respiratory pathology admitted in a pediatric intensive care unit of a low-resource setting: a single-center experience.
Article in Critical care science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine the sensitivity and specificity of lung ultrasound in diagnosing respiratory pathologies in children on respiratory support in the pediatric intensive care unit, compared to chest X-ray and clinical diagnosis.
methodsA cross-sectional study was conducted on children aged 1 month to 18 years admitted to the pediatric intensive care unit and requiring respiratory support from June 2018 to February 2019. Lung ultrasound was performed within 24 hours of chest X-ray by a trained sonographer using standardized protocols. Lung ultrasound and chest X-ray were interpreted independently by blinded physicians. A Receiver Operating Characteristic curve was generated to assess lung ultrasound diagnostic performance using chest X-ray as the gold standard.
resultsA total of 220 lung ultrasounds were performed on 117 patients, with 195 (88.6%) examinations completed. Lung ultrasound and chest X-ray were reported normal in 24 (10.9%) and 21 (9.5%) studies, respectively, with no pneumothorax detected. Overall, lung ultrasound had a sensitivity of 89.95% and specificity of 19.05% compared to chest X-ray. Sensitivity and specificity for pneumonia and pediatric acute respiratory distress syndrome were 62.8% and 44.8%, and 50% and 96%, respectively. Using clinical diagnosis as reference, sensitivity and specificity for pneumonia and pediatric acute respiratory distress syndrome were 59.8% and 54.3%, and 72.7% and 95.7%, respectively. Agreement between chest X-ray and lung ultrasound was poor (k = 0.085), though concordance among lung ultrasound providers was high (k = 0.869). Agreement for lung ultrasound and pediatric acute respiratory distress syndrome was highest (k = 0.632) compared with clinical diagnosis. Receiver Operating Curve analysis showed that lung ultrasound showed poor diagnostic accuracy compared to chest X-ray (AUC 0.54).
conclusionLung ultrasound is feasible in low-resource pediatric intensive care unit settings but shows limited diagnostic accuracy compared to chest X-ray.
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