Lung ultrasound-driven improvements in pneumonia detection, antibiotic stewardship, and ventilation outcomes: A three-era study in a pediatric cardiac surgical intensive care unit.

Bronchoalveolar lavage positivity declined significantly from 70.8% in the pre-lung ultrasound era to 42.4% and 43.6% in the later eras ( P = 0.0018).

Among bronchoalveolar lavage-positive cases, antibiotic escalation increased progressively (52.9%, 62.3%, and 88.5%; P = 0.00027), while blind escalation among bronchoalveolar lavage-negative patients decreased markedly (50.0%, 20.8%, and 8.9%; P = 0.00060).