Predicting severity and etiology of acute lower respiratory tract infections with lung ultrasound
BACKGROUND: Lower respiratory tract infections (LRTIs) impose a disproportionate burden on child health in low- and middle-income countries (LMICs) and are the leading cause of death globally in children ≤5 years. Lung ultrasound (LUS) has been established as a diagnostic tool for pediatric LRTI with performance equal or superior to chest radiography (CXR).
GAP: To date, few studies have explored expanding LUS applications beyond LRTI diagnosis. This study aims to evaluate the performance of LUS in predicting LRTI severity and etiology to guide triage and management of patients with LRTI in Sri Lanka.
HYPOTHESIS: LRTI severity and etiology can be predicted in Sri Lanka with good performance using LUS in conjunction with readily available patient data.
METHODS: This study will first assess the performance of LUS to predict LRTI severity (defined as occurrence of intensive care or death) and LRTI etiology (bacterial vs non-bacterial) in a welldefined prospective cohort of patients with LRTI at a large tertiary referral center in Sri Lanka. A prediction model incorporating quantitative LUS scores and other readily available patient data will then be developed for early identification of severe LRTIs.
IMPACT: Establishing the utility of LUS for timely diagnosis and triage of pediatric LRTIs would aid Sri Lankan providers in allocation of limited resources proven to reduce mortality. As ultrasound machines are available in many Sri Lankan hospitals, point-of-care LUS could be implemented country-wide. Moreover, establishing the utility and feasibility of LUS for LRTI management in Sri Lanka will encourage expanded applications of LUS in similar LMICs.