Prospective Comparative Study Between Bedside Ultrasonography and Computed Topography of Chest for The Diagnosis and Progression of Pneumonia in Critical Care

Nour El-Din, Tawfik Mohamed; Ewieda, Tamer Mohamed Ahmed; El-Sayed, Ahmed Mahmoud Shehata

doi:https://doi.org/10.21608/aimj.2025.446669

Prospective Comparative Study Between Bedside Ultrasonography and Computed Topography of Chest for The Diagnosis and Progression of Pneumonia in Critical Care

Document Type : Original Article

Authors

¹ Professor of Anesthesia and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

² Assistant Professor of Anesthesia and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

³ MSc, Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446669

Abstract

Background: The diagnostic gold standard is a thoracic computed tomography (CT) scan, which has severe drawbacks such as a high radiation dose, a high price tag, and limited accessibility. A growing number of thoracic diseases, such as empyema, pneumothorax, pulmonary embolism, pneumonia, and pleural or pericardial effusion, are being diagnosed by bedside ultrasonography (BUS).
Aim and objectives: The main goal is to compare the sensitivity and specificity of CT-chest and lung ultrasonography for emergency room pneumonia diagnosis. Evaluation of the progression of pneumonia by ultrasonography (U/S) in comparison to chest computed tomography (CT) is a secondary outcome.
Subjects and methods: In this prospective observational study, 50 adults were chosen from the emergency department patients of Al-Azhar University Hospitals who were suspected of having pneumonic disease based on their medical history and physical examination throughout the period from February 2023 to February 2025.
Results: Pneumonia and pleural effusion were significantly lower at the 7th day than at admission, as detected by BUS. Pneumonia and pleural effusion were significantly lower at the 7th day than at admission, as detected by chest CT. Size of pneumonic patches by BLUS was<1cm in 19(52.78%) patients and>1cm in 17(47.22%) patients. The size of pneumonic patches by CT was<1cm in 22(56.41%) patients and>1cm in 17(43.59%) patients.
Conclusion: BLUS effectively detected reductions in both conditions over the observation period, and these findings were mirrored by a statistically significant decrease in CRP levels, reflecting clinical improvement. While BLUS demonstrated strong sensitivity and specificity, its limitations in negative predictive value suggest that its optimal use lies in combination with CT.

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