The Effectiveness of Lung Ultrasound for Diagnosis of Ventilator Associated Pneumonia Compared to standard radiological strategies | ||
Zagazig University Medical Journal | ||
Articles in Press, Accepted Manuscript, Available Online from 21 October 2025 | ||
Document Type: Original Article | ||
DOI: 10.21608/zumj.2025.432814.4260 | ||
Authors | ||
Mohamed Abd-Elkareem Rabea1; Mona Abdel Hamid Elharrisi* 2; Neven Mohamed Gamil2; Mohamed Gamal Nada3; Mohamed Lofty Mohamed4 | ||
1Anesthesia, Intensive care and pain management Department, Faculty of Medicine, Zagazig University, Egypt | ||
2Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Zagazig University, Egypt | ||
3Assistant professor of Diagnostic Radiology, Faculty of Medicine, Zagazig University, Egypt | ||
4Lecturer of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Zagazig University, Egypt | ||
Abstract | ||
Background: The common and dangerous ICU-acquired infection known as ventilator-associated pneumonia raises morbidity, mortality, antibiotic use, and healthcare costs. This study aimed to evaluate the effectiveness of lung ultrasound as a simple bedside tool for the early diagnosis of ventilator-associated pneumonia compared with the standard radiological diagnostic strategy, and to assess its impact on patient outcomes. Methods: This prospective randomized controlled study was conducted on 126 mechanically ventilated adult patients who admitted to the surgical and emergency ICUs of Zagazig University Hospitals from January to July 2024. Patients were randomly assigned into two groups: the control group (n=63), diagnosed using chest X-ray and CT, and the lung ultrasound group (n=63), assessed primarily using daily lung ultrasound monitoring. Clinical, radiological, and laboratory data were collected, and outcomes included diagnostic accuracy, ventilator-free days (VFDs), SOFA score, ICU stay length, and mortality. Results: The lung ultrasonography group experienced a considerably shorter duration from ICU admission to VAP diagnosis than the control group (5.08±1.6vs. 6.35±1.8days, p<0.001). After a week, patients in the LUS group had significantly less SOFA scores, shorter ICU stays, and ventilator-free days. (p<0.001 for all). The diagnostic performance of LUS showed 84.62% sensitivity, 66.67% specificity, 80.49% PPV, 72.73% NPV, and 77.78% accuracy, outperforming conventional radiology. Logistic regression analysis identified pleural effusion detected by LUS at 72 hours as a significant independent predictor of mortality (p<0.001). Conclusion: Lung ultrasound is a reliable, safe, and accurate bedside modality for the early detection and monitoring of VAP, enabling earlier intervention and improved clinical outcomes. | ||
Keywords | ||
Lung ultrasonography, ventilator-associated pneumonia, bedside diagnosis, intensive care unit; Mechanical ventilation | ||
Statistics Article View: 2 |