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Edelman J, Taylor H, Goss AM, Tisovszky N, Sun KM, O'Toole S, Herriotts K, Inglis E, Johnson C, Penfold S, Bull J, Shires P, Towers A, Griksaitis MJ. Point-of-care ultrasound as a diagnostic tool in respiratory assessment in awake paediatric patients: a comparative study. Arch Dis Child 2024; 109:287-291. [PMID: 38123921 DOI: 10.1136/archdischild-2023-325975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Chest X-ray (CXR) has typically been the main investigation in children with suspected respiratory pathology. Recent advances in lung point-of-care ultrasound (POCUS) have shown the potential for it to be comparative, if not better, than CXR. The objective of this study was to compare CXR with lung POCUS in children with respiratory illness in a ward-based setting at a paediatric teaching hospital. METHODS Any child <18 years of age presenting to Southampton Children's Hospital requiring a CXR for clinical reasons also had lung POCUS performed. CXR was reported by a consultant paediatric radiologist and lung POCUS was reviewed retrospectively by a blinded POCUS clinician, with only the clinical information provided on the CXR request. Comparisons were made between the CXR and lung POCUS findings. RESULTS 100 paired lung POCUS and CXR were included in the study. 30% of lung POCUS were normal with 97% of these having a normal CXR. 70% of cases had POCUS abnormalities with 96% of POCUS cases identifying comparative lung pathology. Lung POCUS therefore had a sensitivity of 98.51% and a specificity of 87.9% with a diagnostic accuracy of 95% when compared with the CXR report. CONCLUSIONS Lung POCUS has excellent diagnostic accuracy. The diagnosis of normal lung on POCUS when performed by a trained practitioner can reliably reduce the need for a CXR, thus reducing CXR use and radiation exposure in children. An abnormal lung POCUS could then either give the diagnosis or lead to a CXR with the expectation of clinically relevant findings.
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Affiliation(s)
- James Edelman
- Paediatric High Dependency Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
| | - Hannah Taylor
- Paediatric Outreach Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Anne-Marie Goss
- Paediatric High Dependency Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
| | - Natasha Tisovszky
- Paediatric High Dependency Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
| | - Kang Min Sun
- Paediatric High Dependency Unit, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
| | - Sophie O'Toole
- Paediatric Outreach Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kate Herriotts
- Paediatric Outreach Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Elizabeth Inglis
- Paediatric Outreach Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Chloe Johnson
- Paediatric Outreach Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Scott Penfold
- Paediatric Outreach Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jenny Bull
- Paediatric Outreach Team, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter Shires
- Paediatric Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ashley Towers
- Paediatric Emergency Department, Queen Alexandra Hospital, Portsmouth, UK
| | - Michael J Griksaitis
- Paediatric Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- University of Southampton Faculty of Medicine, Southampton, UK
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Champion de Crespigny C, Shetty P, Inglis E, Anpalagan A, Chatterjee U, Alahakoon TI. Successful pregnancy with fundal placenta percreta replacing the myometrial defect from previous uterine rupture. J OBSTET GYNAECOL 2019; 39:853-855. [PMID: 30915874 DOI: 10.1080/01443615.2018.1557125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - P Shetty
- b Westmead Institute for Maternal and Fetal Medicine , Westmead Hospital , Westmead , Australia
| | - E Inglis
- a Department of Obstetrics and Gynaecology , Westmead Hospital , Westmead , Australia
| | - A Anpalagan
- a Department of Obstetrics and Gynaecology , Westmead Hospital , Westmead , Australia
| | - U Chatterjee
- a Department of Obstetrics and Gynaecology , Westmead Hospital , Westmead , Australia
| | - T I Alahakoon
- b Westmead Institute for Maternal and Fetal Medicine , Westmead Hospital , Westmead , Australia.,c Westmead Clinical School , The University of Sydney , Sydney , Australia
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