Lung Ultrasound to Detect Pneumothorax in Children Evaluated for Acute Chest Pain in the Emergency Department: An Observational Pilot Study

Frontiers in Pediatrics

article

Barbara Scialanga¹  Danilo Buonsenso²  Simona Scateni¹  Piero Valentini²  Paolo Maria Salvatore Schingo⁵  Elena Boccuzzi¹  Maria Alessia Mesturino¹  Valentina Ferro¹  Antonio Chiaretti²  Alberto Villani¹  Maria Chiara Supino¹  Anna Maria Musolino¹ 

[1] Department of Emergency, Acceptance and General Pediatrics, Institute for Research and Health Care ,(IRCCS), Bambino Gesù Children's Hospital;Department of Woman and Child Health and Public Health, Institute for Research and Health Care ,(IRCCS), Fondazione Policlinico Universitario A. Gemelli;Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli, Institute for Research and Health Care;Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore;Department of Diagnostic Imaging, Institute for Research and Health Care ,(IRCCS), Bambino Gesù Children's Hospital

关键词: pneumothorax;    children;    lung ultrasound;    lung point;    PNX;    chest pain;    pediatric;    emergency department;   

DOI  :  10.3389/fped.2022.812246

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Spontaneous pneumothorax is a relatively uncommon and poorly studied condition in children. While several protocols have been developed to evaluate the use of lung ultrasound for dyspneic adult patients in the emergency department, no specific guidelines are present for pediatric emergency physicians. Objectives We prospectively analyzed children with acute chest pain and clinical suspicion of pneumothorax evaluated at the pediatric emergency department. Methods We consecutively enrolled children aged 5–17 years presenting to the pediatric emergency department with clinically suspected pneumothorax based on sudden onset of acute chest pain. After clinical examination, all children underwent lung ultrasound followed by chest X-ray (reference standard). We enrolled 77 children, of which 13 (16.9%) received a final diagnosis of pneumothorax. Results The lung point had a sensitivity of 92.3% (95% CI 77.8–100) and a specificity of 100% (95% CI 94.4–100) for the detection of pneumothorax. The “barcode sign” had a sensitivity of 100% (95% CI 75.3–100) and a specificity of 100% (95% CI 94.4–100) for the detection of pneumothorax. Conclusion Lung ultrasound is highly accurate in detecting or excluding pneumothorax in children with acute chest pain evaluated in the pediatric emergency department. If pneumothorax is suspected, but the lung point is not visible, the barcode sign should always be sought as it could be a form of massive pneumothorax.

【 授权许可】

CC BY