Study design
The study was performed in the pediatric emergency department of the Dokuz Eylul University Faculty of Medicine. Previously healthy children between 1 month and 18 years of age were included. Patients were excluded if they had life-threatening diseases requiring immediate intervention; chronic pulmonary, cardiac, or neuromuscular diseases; diaphragmatic hernia; diaphragm paresis; chest wall abnormalities; genetic disorders; or history of cardiac/thoracic operation or prematurity (<34 gestational week). The patients who presented to the pediatric emergency department with suspicious clinical symptoms, physical examination findings, and infiltration on CXR (if performed) were considered as having suspected pneumonia and all of them were examined by LUS. If pneumonia was confirmed by LUS, then the patients were enrolled in the study and DUS was performed. The Pediatric Respiratory Severity Score (PRESS) was used to indicate the severity of the disease. This scoring system comprises respiratory rate, wheezing, use of accessory muscles, refusal to feed, and oxygen saturation SpO2 of <95% in room air. Each parameter was scored with 0 or 1 point and the total score was classified as mild (0–1 points), moderate (2–3 points), or severe (4–5 points) ¹⁷. The demographic, clinical, and laboratory data of the patients were recorded together with LUS findings, DUS parameters, and PRESS scores by a pediatric emergency fellow at admission. Vital findings were monitored by a nurse and the patients were evaluated by a pediatric assistant and a pediatric emergency fellow. Length of stay in the pediatric emergency department, need for hospitalization, and length of total stay in the hospital were recorded.