Feasibility and safety of ultrasound-aided thoracentesis in mechanically ventilated patients

Lichtenstein, David R.; Hulot, Jean‐Sébastien; Rabiller, Anne; Tostivint, Isabelle; Mézière, Gilbert

doi:10.1007/s001340050988

Cited by 261 publications

(180 citation statements)

References 9 publications

(7 reference statements)

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“…In other conditions, such as complex effusion and in patients where pleural effusion is suspected, the sonographic technique can benefit from standardized criteria to improve diagnostic accuracy. The sinusoid sign is a dynamic sign showing the variation of the interpleural distance during the respiratory cycles [69,70]. This variation is easily visualized on M-mode as a sinusoid movement of the visceral pleura [70].…”

Section: Rl-d4-s2 (Strong: Level B)mentioning

confidence: 99%

International evidence-based recommendations for point-of-care lung ultrasound

et al. 2012

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Background: The purpose of this study is to provide evidence-based and expert consensus recommendations for lung ultrasound with focus on emergency and critical care settings. Methods: A multidisciplinary panel of 28 experts from eight countries was involved. Literature was reviewed from January 1966 to June 2011. Consensus members searched multiple databases including Pubmed, Medline, OVID, Embase, and others. The process used to develop these evidence-based recommendations involved two phases: determining the level of quality of evidence and developing the recommendation. The quality of evidence is assessed by the grading of recommendation, assessment, development, and evaluation (GRADE) method. However, the GRADE system does not enforce a specific method on how the panel should reach decisions during the consensus process. Our methodology committee decided to utilize the RAND appropriateness method for panel judgment and decisions/consensus. Results: Seventythree proposed statements were examined and discussed in three conferences held in Bologna, Pisa, and Rome. Each conference included two rounds of face-to-face modified Delphi technique. Anonymous panel voting followed each round. The panel did not reach an agreement and therefore did not adopt any recommendations for six statements. Weak/ conditional recommendations were made for 2 statements, and strong recommendations were made for the remaining 65 statements. The statements were then recategorized and grouped to their current format. Internal and external peer-review processes took place before submission of the recommendations. Updates will occur at least every 4 years or whenever significant major changes in evidence appear. Conclusions: This document reflects the overall results of the first consensus conference on ''point-of-care'' lung ultrasound. Statements were discussed and elaborated by experts who published the vast majority of papers on clinical use of lung ultrasound in the last 20 years. Recommendations were produced to guide implementation, development, and standardization of lung ultrasound in all relevant settings.

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Section: Rl-d4-s2 (Strong: Level B)mentioning

confidence: 99%

International evidence-based recommendations for point-of-care lung ultrasound

et al. 2012

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“…Finally, the location of the diaphragm should be determined, in order to avoid this structure with the needle [19]. In a mechanically ventilated patients, a pleural fluid depth of at least 15 mm visualized over three intercostal spaces has been shown to be associated with a safer thoracentesis [6].…”

Section: Thoracentesis Techniquesmentioning

confidence: 99%

“…In contrast, the pneumothorax rate associated with ultrasound-guided thoracenteses was lower, ranging from 0 to 9.1%. The rates of subsequent chest tube insertion for pneumothoraces ranged from 2.2-7% in those procedures without ultrasound guidance and 0-3.7% in procedures performed with ultrasound guidance [6,13,22,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

Section: Overall Incidence Of Pneumothorax and Impact Of Ultrasoundmentioning

confidence: 99%

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Ultrasound for the Detection of Pleural Effusions and Guidance of the Thoracentesis Procedure

Sikora

Perera

Mailhot

et al. 2012

ISRN Emergency Medicine

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Objective. To review the use of ultrasound for the detection of pleural effusions and guidance of the thoracentesis procedure. Methods. Two clinical cases will be presented in which ultrasound proved beneficial in guiding the diagnosis and management of patients with pleural effusions and respiratory distress. The ultrasound techniques for the evaluation of pleural effusions and performance of the thoracentesis procedure are discussed. A review of the most current literature follows to present the known diagnostic and safety benefits of ultrasound guidance for thoracentesis. Conclusions. Ultrasound improves the diagnostic accuracy for the detection of pleural effusions over standard chest radiographs. Ultrasound can also diagnose a complicated pleural effusion that may be at higher risk for an adverse outcome during a thoracentesis. Optimally, thoracentesis should be performed under direct ultrasound guidance to decrease the complication rate and improve patient safety.

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“…There is no doubt that certain applications of CCUS, such as renal ultrasonography for evaluation of kidney failure [2], pleural ultrasonography for identification and characterization of pleural fluid [3], ultrasonography for diagnosis of deep venous thrombosis [4], and ultrasonography for procedural guidance, should be routine in the intensive care unit. For the latter application, ultrasonography for guidance of vascular access should be considered as mandatory [5], while the use of ultrasonography in the patient on ventilatory support makes thoracentesis both feasible and safe [6].…”

mentioning

confidence: 99%