Google
Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Accuracy of Point-of-care Lung Ultrasonography for Diagnosis of Acute Chest Syndrome in Pediatric Patients with Sickle Cell Disease and Fever
source: Academic Emergency Medicine
year: 2016
authors: Daswani DD, Shah VP, Avner JR, Manwani DG, Kurian J, Rabiner JE
summary/abstract:OBJECTIVES:
The objective was to determine the test performance characteristics for point-of-care lung ultrasonography (LUS) performed by pediatric emergency medicine (PEM) physicians compared with radiographic diagnosis of acute chest syndrome (ACS) in patients with sickle cell disease (SCD) and fever.
METHODS:
This was a prospective study of patients up to 21 years with SCD and fever requiring chest X-ray (CXR) evaluation for ACS. Before obtaining CXR, a blinded PEM physician performed LUS using a standardized scanning protocol. Positive LUS for ACS was defined as lung consolidation. All patients received CXR and follow-up. The criterion standard for ACS was consolidation on CXR as determined by a blinded radiologist. LUS clips were reviewed by a blinded expert PEM sonologist.
RESULTS:
A total of 116 febrile events from 91 patients with a median age of 5.7 years were enrolled by 15 PEM sonologists. CXR was positive for ACS in 15 (13%) patients, and LUS was positive for ACS in 19 (16%) patients. Positive LUS had a sensitivity of 87% (95% confidence interval [CI] = 62% to 96%), specificity of 94% (95% CI = 88% to 97%), positive likelihood ratio of 14.6 (95% CI = 6.5 to 32.5), and negative likelihood ratio of 0.14 (95% CI = 0.04 to 0.52) for ACS. The interobserver agreement (kappa) was 0.77. There were two missed cases of ACS on LUS.
CONCLUSIONS:
LUS may be sensitive and specific for diagnosis of ACS in pediatric patients with SCD and fever. LUS may reduce the need for routine CXR and associated ionizing radiation exposure in this population.
DOI: 10.1111/acem.13002
read more full text
+myBinderRelated Content
-
Researchers ID key drivers of heart complications in sickle cell anemiaStudy opens path to earlier diagnosis, t...
-
Magnesium for treating sickle cell diseaseBACKGROUND: Sickle cell disease is an a...
-
Associations of Prolonged QTc in Sickle Cell DiseaseSudden death is a leading cause of morta...
-
Sickle Cell Retinopathyhttps://www.youtube.com/watch?v=tCgAHWvV...
-
Sickle Cell Disease Research Shows Progress in Preventing Related Complications and DeathStudies aim to limit pain crises, preven...
-
Small chips, big impact: MSU researcher studies cardiovascular, sickle cell diseaseA Mississippi State University researche...
-
FDA Awards $2M to Phase 2 Trial of Vitamin D for Reducing Risk of SCD Respiratory ComplicationsThe U.S. Food and Drug Administration (F...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.
Powered by
Support for this site is provided by
This platform is made possible through a partnership with the Sickle Cell Disease Association of America, Inc. (SCDAA) and its member organizations. SCDAA's mission is to advocate for people affected by sickle cell conditions and empower community-based organizations to maximize quality of life and raise public consciousness while advancing the search for a universal cure.