Community-Acquired Pneumonia Diagnosis Using Lung Ultrasound in Emergency Room Adults (CAPUERA)

Centre Hospitalier Universitaire de Nice

Status: Active, not recruiting

Conditions: Community-acquired Pneumonia

Treatments: Diagnostic Test: Lung Ultrasound (LUS); Diagnostic Test: Chest radiography (CR)

Study type: Interventional

Funder types: Other

Identifiers

NCT04210102

17-14

Details and patient eligibility

About

Community-Acquired Pneumonia (CAP) is a major problem in Emergency Department (ED). Diagnosis relies on combination of clinical symptoms and results of chest radiography (CR). Patients' management (treatment, support) depends on delay and quality of the diagnosis. However, signs and symptoms are highly aspecific and interpretation of CR is subject to frequent discrepancies. Then diagnosis of CAP may be uncertain; therefore, overdiagnosis is frequent and leads to over-use of antimicrobial therapy; missing diagnosis is also deleterious and delays adequate treatment including antibiotics. CT scan completes CR and helps clinician making properly diagnosis of CAP; obtaining CT in a 4-hour time-lapse allows better diagnosis and management as accurate as an independent expert adjudication committee does. However availability of CT as well as radiation interrogates on the benefit that Lung Ultrasounds (LUS) may have in diagnosis strategy of suspected CAP. LUS is a noninvasive easy-to-use device whose practice is widely endorsed worldwide by emergency medicine associations and societies. Additionally, previous studies advocate for the use of LUS for diagnosis of CAP in the ED. Therefore the Promotor developed a study to compare LUS and CR as a primary imaging for diagnosis of CAP at the ED.

Enrollment: 47 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients (18+)
• Suspected CAP by attending emergency physician
• And new onset of systemic infection (at least one among sweat, chills, aches and pain, temperature ≥38°C or <36°C)
• And symptoms of an acute lower respiratory tract infection (at least one among cough, sputum production, dyspnea, chest pain, altered breathing sounds at auscultation
• No previous imaging for the current medical problem
• Inform consent (signed)
• Affiliation to insurance (France, Monaco)

Exclusion criteria

• Age below 18-year of age
• Patients in palliative care
• Pregnant women
• anticipated barriers to completing follow-up data collection,
• patients classified three or higher according to the CRB65 score,
• patients requiring intensive care for any purpose because of specific management of critically ill
• refusal to participate to the study

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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47 participants in 2 patient groups

CR + LUS

Other group

Description:

Patient will be performed first the Chest radiography then the Lung ultrasound.

Treatment:

Diagnostic Test: Chest radiography (CR)

Diagnostic Test: Lung Ultrasound (LUS)

LUS + CR

Other group

Description:

Patient will be performed first the Lung ultrasound then the Chest radiography

Treatment:

Diagnostic Test: Chest radiography (CR)

Diagnostic Test: Lung Ultrasound (LUS)