Point-of-Care Lung Ultrasound in Pediatric Emergency Care: Diagnostic Accuracy for Pneumonia and Differentiation of Other Causes of Respiratory Distress

Abstract

Objective: To analyze the scientific evidence on the diagnostic accuracy of point-of-care lung ultrasound for identifying pneumonia and its contribution to differentiating other causes of respiratory distress in pediatric patients. Methods: A comparative literature review was conducted, guided by PRISMA recommendations for reporting the study selection process. Of 140 studies initially assessed, seven were selected for analysis, including observational studies, systematic reviews with meta analysis, a narrative review, a case series, and a conference abstract. Study designs, populations, diagnostic accuracy measures, and major methodological limitations were compared. Results: The meta-analyses reported a pooled sensitivity of approximately 91% for lung ultrasound in diagnosing pediatric pneumonia, with specificity ranging from 80.7% to 86%. One prospective observational study reported a sensitivity of 99.11% and a specificity of 81.48%, whereas a study conducted in a pediatric intensive care unit found lower diagnostic performance. Lung ultrasound also showed potential for detecting pulmonary consolidations and pleural effusions. Conclusion: Point-of-care lung ultrasound is a promising tool for evaluating suspected pneumonia in children, offering advantages related to portability, rapid assessment, and the absence of ionizing radiation. Nevertheless, its use requires adequate training and integration with clinical assessment. Further studies are needed to clarify its role in differential diagnosis and its impact on clinical outcomes.