The "lung point": an ultrasound sign specific to pneumothorax

Lichtenstein, David R.; Mézière, Gilbert; Biderman, Philippe; Gepner, Agnès

doi:10.1007/s001340000627

Cited by 620 publications

(432 citation statements)

References 3 publications

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“…It allows prompt detection of life-threatening conditions, such as hemothorax or pneumothorax, and it has proved to be extremely helpful in accelerating the differential diagnosis of acute respiratory distress in critically ill patients [4][5][6]. It has been shown to have very high sensitivity and specificity in the detection of pneumothorax and outperforms plain chest radiography in emergency settings [4][5][6][7][8][9][10][11][12][13][14][15]. Ultrasonographic diagnosis of pneumothorax is based on the absence of two specific findings.…”

Section: Riassuntomentioning

confidence: 99%

Thoracic ultrasound confirmation of correct lung exclusion before one-lung ventilation during thoracic surgery

et al. 2013

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Introduction Fiberoptic bronchoscopy is the standard method for verifying the correct position of a double-lumen endotracheal tube (DLET) prior to one-lung ventilation. However, it must be performed by a specially trained anesthesiologist and is often resource consuming. The aim of this study was to compare this approach with thoracic ultrasound done by a nurse anesthetist in terms of sensitivity, specificity, and cost-effectiveness. Methods We conducted a prospective cross-over casecontrol study involving 51 adult patients consecutively undergoing thoracic surgery with one-lung ventilation. After orotracheal intubation with a DLET, correct exclusion of the lung being operated on exclusion was assessed first by a certified anesthesiologist using standard fiberoptic bronchoscopy and then by a trained nurse anesthetist using thoracic ultrasound. The nurse was blinded as to the findings of the anesthesiologist's examination. Results The two approaches proved to be equally sensitive and specific, but the ultrasound examination was more rapid. This factor, together with the fact that ultrasound was performed by a nurse instead of a physician, and the costs of materials and sterilization, had a significant economic impact amounting to a net saving of €37.20 ± 5.40 per case. Conclusions Although fiberoptic bronchoscopy is still the gold standard for checking the position of a DLET, thoracic ultrasound is a specific, sensitive, cost-effective alternative, which can be used to rapidly verify the proper function of the tube based on the demonstration of correct lung exclusion.Keywords Thoracic ultrasound Á Anesthesia Á Thoracic surgery Riassunto Introduzione La fibrobroncoscopia è attualmente la tecnica di scelta per la verifica di un corretto posizionamento del tubo endotracheale a doppio lume, prima dell'esclusione polmonare necessaria alla ventilazione monopolmonare. Tale tecnica richiede tuttavia un medico anestesista specialista adeguatamente formato ed è dunque spesso costosa. Scopo dello studio è di compararla all'ecografia toracica effettuata da infermieri anestesisti, in termini di sensibilità, specificità e costo-efficacia. Metodi Abbiamo dunque realizzato uno studio casocontrollo, cross-over, in effettuata da un infermiere anestesista specificamente formato.una coorte continua di pazienti adulti sottoposti a chirurgia toracica in ventilazione monopolmonare. Dopo intubazione oro-tracheale con tubo doppio lume, ciascun paziente è stato sottoposto dapprima a controllo fibrobroncoscopico effettuato da un medico anestesista e successivamente ad ecografia toracica effettuata da un infermiere anestesista specificamente formato per determinare una corretta esclusione del polmone operato. L'infermiere non era a conoscenza dei risultati del controllo fibrocroncoscopico. Risultati Le due tecniche sono risultate comparabili in termini di sensibilità e specificità. L'ecografia toracica è risultata una tecnica significativamente più rapida da eseguire rispetto alla fibrobroncoscopia. Il tempo di esecuzione, unitament...

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Section: Riassuntomentioning

confidence: 99%

Thoracic ultrasound confirmation of correct lung exclusion before one-lung ventilation during thoracic surgery

et al. 2013

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“…A homogeneous grainy pattern will appear below the pleural line, generated by the pleura in constant motion showing the appearance of a sandy beach, referred to as the ''seashore sign'' (Fig. 4) [26]. The image of lung sliding may be exaggerated at power Doppler, which is more sensitive to movement than color Doppler, as there is power Doppler signal also from a slight movement but no signal when the pleura is immobile (''Power slide'') [27].…”

Section: Chest and Pleura Efastmentioning

confidence: 99%

“…The ''lung point'' finding is diagnostic of pneumothorax with a sensitivity of 66 % and a specificity of 100 % [26]. The ''lung point'' can be visualized also using the M-mode, which shows the shifting from ''seashore sign'' to ''stratosphere sign'' and vice versa.…”

Section: Pneumothoraxmentioning

confidence: 99%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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Objectives The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients. Methods A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles. Results 80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients. Conclusions US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions. Keywords Trauma Á Ultrasound Á Ultrasound findings Á Ultrasound techniqueRiassunto Obiettivi L'obiettivo di questa ricerca è di presentare la visione e le opinioni correnti sul ruolo dell'ecografia nella gestione del paziente con politrauma. L'articolo è diviso in due parti: nella prima ('Semeiotica ecografica e tecnica di esecuzione dell'esame') verrà data attenzione agli aspetti prevalentemente tecnici dell'ecografia nel trauma, con intento anche didattico; nella seconda (Fisiopatologia e ecografia clinica del trauma) sarà esplorato il tema dell'integrazione dell'ecografia con la clinica e la fisiopatologia nella gestione del politraumatizzato. Metodi Revisione non sistematica della letteratura. Ricerca su PubMed (restrizione agli ultimi 10 anni) di articoli originali e revisioni. Risultati Per la Parte prima sono stati selezionati 80 articoli, tra i quali sono stati scelti con criteri personali quelli ritenuti innovativi o originali nei contenuti (48 articoli originali, 2 revisioni di letteratura). 19 articoli sono stati estratti dalla bibliografia delle pubblicazioni prescelte. I contenuti estratti dai 69 articoli sono stati organizzati in paragrafi intitolati ai singoli ambiti di applicazione dell'ecografia nel politrauma. Conclusioni L'ecografia del trauma è evoluta dalla iniziale applicazione nella diagnosi precoce del versamento peritoneale (Focused Abdominal Sonography for Trauma o FAST) all'accezione più ampia di Resuscitative Ultrasonography (RUS) e v...

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“…At that point, lung function is still not impaired and maximal left ventricular output can be expected. The potential of lung ultrasound in diagnosing pneumothorax, potentially reversible cause of shock and arrest, can be extremely helpful in some cases (29)(30)(31).…”

Section: Lung Ultrasoundmentioning

confidence: 99%

Assesment of hemodynamics by basic ultrasound

Radonić¹

2017

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Basic ultrasound can provide important information about the main parts of the circulatory system, the heart, and the main vessels. At the bedside, only by brief visual impression of the heart function and inferior vena cava diameter, and without any measurements, the attending physician can get important information which can influence the clinical opinion-making process and the management of the hemodynamically unstable patient. No less important is to obtain information about the lungs, particularly to estimate if extravascular lung water is present in excess or not. Ultrasound can help in the detection of the potentially reversible causes of hemodynamic instability or arrest and can guide the treatment. Examples are pneumothorax, cardiac tamponade, thromboembolism, the detection of blood in the pleural, pericardial or abdominal space after trauma and the detection and treatment of the source of the infection.

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The "lung point": an ultrasound sign specific to pneumothorax

Abstract: The presence of a "lung point" allows positive diagnosis of pneumothorax at the bedside using ultrasound.

Cited by 620 publications

References 3 publications

Thoracic ultrasound confirmation of correct lung exclusion before one-lung ventilation during thoracic surgery

Thoracic ultrasound confirmation of correct lung exclusion before one-lung ventilation during thoracic surgery

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Assesment of hemodynamics by basic ultrasound

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