Clinical application of transthoracic ultrasonography in inpatients with pneumonia

P>Purpose The aim of this study was to investigate the clinical applicability of transthoracic ultrasound (TUS) in the diagnosis and follow-up of community acquired pneumonia (CAP). Methods We designed a pilot study in 15 patients and subsequently investigated 342 patients (206 men and 136 women) consecutively admitted to our Department from September 2005 to November 2009 because of radiographically diagnosed CAP. All patients underwent standard chest radiography, and consequently TUS. Follow-up TUS were performed at 4th and 8-10th day, in most patients. Results Concerning the reproducibility of TUS method, no reader's bias was present (P = 0 center dot 18), overall variability and between-subject variability (inter-reader agreement) did not show any difference between readers (P = 0 center dot 62 and P = 0 center dot 32 respectively), and estimated within-subject variabilities (intra-reader agreement) suggested a very high repeatability of the method (P similar to 1). Of 342 patients with Rx diagnosis of CAP, in 314 patients (92% of cases) a pulmonary consolidation was also detected using TUS, whose ultrasonographic patterns were studied. Pleural effusion was detected in 120/342 (35%) patients using ultrasound and in 111/342 (32%) patients using chest radiography. Overall dimensional changes of the lung consolidated areas assessed with TUS method showed highly significant results. (1st day mean +/- SD: 66 center dot 34 +/- 19 center dot 25; 4th day: 39 center dot 92 +/- 14 center dot 61; 8-10th day: 7 center dot 41 +/- 1 center dot 50; P < 0 center dot 0001). Conclusions TUS is easily reproducible and we proved it to be a useful complementary diagnostic tool for the diagnosis and the follow-up of CAP.