Chest ultrasound in the evaluation of complicated pneumonia in the ICU patients: Can be viable alternative to CT?

Abstract

Objective: To compare ultrasound (US) and computed tomography (CT) for evaluating patients with complicated pneumonia admitted to the intensive care unit (ICU) to assess if US can be an alternative to CT. Subjects and methods: We prospectively compared US and CT findings in 48 patients admitted to the ICU with complicated pneumonia with their final diagnosis at discharge. Images were evaluated for parenchymal findings (consolidation, necrosis, and abscess) and pleural findings (effusion, loculation or fibrin strands in the pleural fluid). Results: US was similar to CT in the evaluation of parenchymal and pleural abnormalities except for two patients with consolidation and effusion, three patients with loculated effusion, one patient with pulmonary necrosis and another patient with lung abscess. US was superior to CT in detection of fibrin strands within pleural effusion. Conclusion: Chest US provides an accurate evaluation of the pleural and parenchymal abnormalities associated with complicated pneumonia in the ICU patients. Considering that chest US is a bedside and avoids transportation of the patient outside ICU, free of radiation exposure and easily repeatable, chest US appears to be an attractive alternative to CT.

Keywords

• US
• CT
• ICU
• Pneumonia
• Pleural effusion