Validity of lung ultrasound with bedside lung ultrasonography in emergency protocol in diagnosing pneumonia

Putu Gita Indraswari; Ni Wayan Candrawati; Dewa Gde Mahiswara Suadiatmika; I. Gede Ketut Sajinadiyasa; Ni Luh Putu Eka Arisanti; I. Desak Putu Agung Krisdanti

doi:10.18203/2349-3933.ijam20243422

Authors

Putu Gita Indraswari Department of Pulmonology and Respiratory Medicine, Prof. I.G.N.G. Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
Ni Wayan Candrawati Department of Pulmonology and Respiratory Medicine, Prof. I.G.N.G. Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
Dewa Gde Mahiswara Suadiatmika Department of Radiology, Prof. I.G.N.G. Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
I. Gede Ketut Sajinadiyasa Department of Pulmonology and Respiratory Medicine, Prof. I.G.N.G. Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
Ni Luh Putu Eka Arisanti Department of Pulmonology and Respiratory Medicine, Prof. I.G.N.G. Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
I. Desak Putu Agung Krisdanti Department of Pulmonology and Respiratory Medicine, Udayana University Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia

DOI:

https://doi.org/10.18203/2349-3933.ijam20243422

Keywords:

Ultrasound, BLUE protocol, Pneumonia, Sensitivity, Specificity, Accuracy

Abstract

Background: Pneumonia is an acute inflammation of the lung parenchyma caused by microorganisms. In 2020, pneumonia was included in the top 10 diseases requiring hospitalization in Indonesia with a mortality rate of 23% for patients treated in the intensive care unit. The diagnosis of pneumonia is based on anamnesis, physical examination, and supporting examinations. However, in practice, diagnostic procedures in patients with immobilization or patients with unstable hemodynamics are difficult to perform. Lung ultrasound (LUS) with bedside lung ultrasonography in emergency (BLUE) protocol is a simple and portable supporting examination that is known to be able to diagnose pneumonia more easily, accurately, and quickly. Therefore, a study related to the validity of LUS in diagnosing pneumonia needs to be conducted.

Methods: This study is a diagnostic test. The study was conducted over a period of 6 months (August 2023 to February 2024) at Prof. Dr. I.G.N.G. Ngoerah hospital. In this study, the validity was assessed consisting of sensitivity, specificity, and accuracy of LUS in diagnosing pneumonia. Data were analyzed using STATA MP 17.

Results: The total subjects in this study were 70 people. The sensitivity of LUS in diagnosing pneumonia was 86.8% (CI95%=74.7-94.5%) and the specificity was 70.6% (CI95%=44-89.7%), with an accuracy of 82.8%. The positive test predictive value was 90.2% (CI95%=78.6-96.7%) and the negative test predictive value was 63.2% (CI95%=38.4-83.7%). Thus, in subjects with LUS suggestive of pneumonia, pneumonia management can be done immediately. However, in subjects with LUS results not showing pneumonia, further supporting examinations are needed to confirm the diagnosis of pneumonia. Sensitivity, specificity, and accuracy varies based on age, body mass index, immunocompromised status, and degree of pneumonia

Conclusions: LUS with BLUE protocol is a valid supporting examination in diagnosing pneumonia (rule in disease).

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