TDNet Discover

Background: In pediatric respiratory emergencies, the chest radiograph is the most used and favored diagnostic test by providers. Although not yet implemented in practice, point-of-care ultrasounds (POCUS) are becoming more favored in pediatric respiratory conditions because they are radiation-free, less costly, and provide accurate results immediately at the patient’s bedside. Objective: To conduct a systematic review examining the applicability and accuracy of a point-ofcare lung ultrasound (POCUS) as the preferred initial diagnostic test for respiratory emergencies in children ages 0-18. Methods: A literature search was conducted from December 2019 to February 2020 of peerreviewed literature within the last 10 years. The databases used were Northeastern University Library, Google Scholar, Medline, and PubMed. Inclusion criteria was point-of-care ultrasound (POCUS), respiratory illnesses, and pediatric patients ages 0-18 years old. Exclusion criteria was any adult populations without a subgroup analysis. Appropriate articles were fulltext and reviewed by researchers independently and in duplicate. Quality assessment and data extraction tools were applied to all remaining articles for analyzation. Results: The combined sensitivity and specificity of POCUS for the ability to predict treatment outcomes in pediatric respiratory conditions was 91.4% and 90.68, respectively. With respect to diagnostic ability, the combined sensitivity and specificity was 95.63% and 85.4%, respectively. In comparison to chest x-ray (CXR), POCUS was more successful at distinguishing lung abnormalities with respect to the control group (p< 0.001), and POCUS had higher diagnostic accuracy (p< 0.05). Conclusion: POCUS is a suitable and superior replacement for CXR as the preferred diagnostic modality for pediatric respiratory emergencies.