الفهرس 
THE BLUE-PROTOCOLOnly 14 pages are availabe for public view
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Abstract
This study was carried out on patients with clinical suspesion of pneumonia who were collected from those admitted at intensive care unit of Benha University Hospitals and intensive care unit of Sheikh Zayed Hospital during the period from February 2022 to July 2022.
A total of 72 patients of either sex, age between 18 to 70 years with clinically suspected Pneumonia. Suspicion was raised clinically (fever 38.0°C,cough, purulent expectoration, dyspnea) and on the basis of typical auscultation findings (rales or bronchial breath sounds) if the patient was not intubated and fever , change in the colour or amount of secretions , auscultatory findings as well as DROP of oxygen saturation below 92% .
This study was conducted to compare the diagnostic value of LUS versus CXR in diagnosis of pneumonia.
All Patients were subjected to radiological examination using chest ultrasound and chest x-ray after admission to surgical ICU.
Each patient underwent a comprehensive LUS assessment including anterior and postero lateral aspects of the chest wall. Patients were investigated in supine, or in a sitting position with raising their arms above head to widen the intercostal space. LUS was performed in six specific points called the BLUE points three on each hemithorax with the transducer orientated either perpendicular or transverse to the chest wall.
CXR was done while patients were positioned supine on a bed for chest x-rays. Films are repeated every other day for follow up.
Findings in ultrasound used for diagnosis of pneumonia (the upper BLUE-point, lower BLUE-point and PLAPS-point (A, A′, B, B′, AB and C profile) were compared with findings in chest x-ray as consolidation appeared.
We found that LUS was superior to conventional CXR in diagnosing pneumonia patients. In addition, we found that LUS was more efficient than CXR in diagnosis of pneumonia in hemodynamically unstable patients. Regarding the duration of imaging, CXR was more time consuming as compared with LUS. Considering that early antibiotic administration in pneumonia patients is associated with better outcomes especially concerning morbidity and mortality, the importance of finding a less time consuming modality for the diagnosis is outstanding.
We concluded that bedside lung ultrasound demonstrated better results than chest X-ray for the early diagnosis of pneumonia.