Use of Lung Sonography in the Assessment and Confirmation of Pulmonary Complications in the Pediatric Patient

To determine if lung sonography is accurate in assessing and confirming pulmonary compromise and thereby reduce the risk of x-ray exposure, for pediatric patients. This study was a systematic review of individual published studies. PubMed was the only database used for the article search. A review by a committee of contributors determined whether studies met the specific inclusion criteria. Studies reviewed had participants between the ages 0 and 18 years, with lung compromise of varying pathophysiological diagnoses. Each intervention was coded by levels of evidence; grading of recommendations, assessment, development, and evaluation (GRADE); the evidence alert traffic light grading system; and risk of bias in nonrandomized studies of interventions. Each article was evaluated using the Cochrane assessment of bias and GRADE evidence tables. Thirty-seven articles were retrieved. Of those, 21 articles were removed following title and abstract screening. With 16 articles remaining, only one duplicate was removed. Based on the 15 articles extracted, in full-text versions, only two articles were noted to be irrelevant, and one article was not provided in English. Only 12 articles met the eligibility criteria, but two articles had to be removed because they were systematic reviews and not individual studies. The final analysis was based on 10 articles that met the inclusion criteria. Once reviewed, all 10 articles indicated that lung sonography had high accuracy and confirmation of lung compromise, which spanned multiple pulmonary diagnoses, in pediatric patients. When used by a trained clinician, lung sonography was as highly effective in comparison to other diagnostic tools, such as a chest radiograph and computed tomography.