Comparative Study of Lung Ultrasound Versus Chest X-ray in Diagnosis of Ventilator Associated Pneumonia in Intensive Care Unit | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2025, Issue 3, March 2025, Page 277-283 PDF (665.41 K) | ||||
| Document Type: Original Article | ||||
| DOI: https://doi.org/10.21608/aimj.2025.446501 | ||||
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| Authors | ||||
Mofeed Abdalla Abdelmaboud1; Mohamed Ahmed El Badawy2; Mohamed Abd El-Rahman Alkenawy 3; Ahmed Abdelghany Abdelaal  4
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| 1Professor of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| 2Lecturer of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| 3Lecturer of Diagnostic and Interventional Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt | ||||
| 4MBBCh, Resident Doctor of Anesthesia, Intensive care and Pain management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. | ||||
| Abstract | ||||
| Background: Despite its critical role in saving lives in the ICU, ventilator-associated pneumonia (VAP) is a common complication of mechanical ventilation that raises healthcare expenses, length of time patients spend on the machine, the number of antibiotics prescribed, and the risk of death. Aim and objectives: To evaluate the efficacy of chest ultrasound compared to chest x-ray in detecting VAP. Subjects and methods: In this prospective cohort study, 58 male patients admitted to Al-Azhar University Hospitals in Cairo, Egypt, with the purpose of diagnosing ventilator-associated pneumonia were included, from February 2024 till December 2024; this study compare Patient data (temperature, TLC, sputum culture, Pao2/Fio2 ratio and PEEP), Ultrasound finding (AB profile, B’ profile, C profile, A+PLAPS profile), X-ray chest finding (focal infiltration, bilateral infiltration, diffuse infiltration), CT chest finding (ground glass opacity, consolidation, nodule, thickened bronchial wall, cavity, bronchiectasis, atelectasis), Specifity, sensitivity and accuracy of chest Us and X-ray. Results: Regarding x-ray findings, focal infiltration in 19(32.76%) patients, bilateral infiltration in 13(22.41%) patients and diffuse infiltration in 15(25.86%) patients. When comparing the use of chest x-ray and lung ultrasound for the diagnosis of ventilator-associated pneumonia, the results were significantly superior for the former (92% vs. 85% specificity, 80% vs. 60% accuracy). There was agreement between CT and lung ultrasonography (Kapaa=0.566) and chest x-ray (Kapaa=0.284), respectively. Conclusion: Although CT results were consistent with both the lung ultrasound and the chest x-ray, the lung ultrasound was more accurate. It demonstrated superior sensitivity, specificity, and accuracy compared to chest x-ray in identifying ventilator-associated pneumonia; it is a fast, dependable diagnostic for use at the bedside. | ||||
| Keywords | ||||
| Lung ultrasound; Chest x-ray; Pneumonia; ICU; VAP | ||||
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