2020
DOI: 10.1183/16000617.0136-2019
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Thoracic ultrasound in the modern management of pleural disease

Abstract: Physician-led thoracic ultrasound (TUS) has substantially changed how respiratory disorders, and in particular pleural diseases, are managed. The use of TUS as a point-of-care test enables the respiratory physician to quickly and accurately diagnose pleural pathology and ensure safe access to the pleural space during thoracentesis or chest drain insertion. Competence in performing TUS is now an obligatory part of respiratory speciality training programmes in different parts of the world. Pleural physicians wit… Show more

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Cited by 31 publications
(24 citation statements)
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References 62 publications
(82 reference statements)
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“…Highly echogenic pleural collections usually represent pus, and the ultrasound appearance is particularly predictive of aspirating purulent fluid in the presence of coarse echogenic “gas bubbles” ( Figure 3A ), which can be seen floating inside the effusion. 46 The presence of septations on ultrasound ( Figure 3B ) is a feature of pleural infection and one of the criteria for differentiating simple from complicated parapneumonic effusion as per the American College of Chest Physicians guidelines on parapneumonic effusion. 47 Recently, the use of the quantitative echogenicity index has been shown to predict the degree of pleural inflammation, which might aid in guiding management.…”
Section: Diagnosismentioning
confidence: 99%
“…Highly echogenic pleural collections usually represent pus, and the ultrasound appearance is particularly predictive of aspirating purulent fluid in the presence of coarse echogenic “gas bubbles” ( Figure 3A ), which can be seen floating inside the effusion. 46 The presence of septations on ultrasound ( Figure 3B ) is a feature of pleural infection and one of the criteria for differentiating simple from complicated parapneumonic effusion as per the American College of Chest Physicians guidelines on parapneumonic effusion. 47 Recently, the use of the quantitative echogenicity index has been shown to predict the degree of pleural inflammation, which might aid in guiding management.…”
Section: Diagnosismentioning
confidence: 99%
“…Point-of-care TUS examination has improved the management of pleural diseases, enhancing safety and efficacy. 1 It currently is considered essential before any pleural fluid drainage procedure. 2 In addition, TUS examination can be useful in cases of loculated pneumothorax, in conjunction with CT scans, to determine diaphragm position and choose a safe entry point, as demonstrated in this case.…”
Section: Discussionmentioning
confidence: 99%
“…The patient who was on dual anti-platelet therapy required an urgent ICD for his pneumothorax. More recently, direct visualization of the intercostal artery with Doppler has been suggested [9], and perhaps this might have prevented the one case of intercostal artery rupture. Local training is ongoing but challenging given the wide range of practitioners that perform pleural procedures.…”
Section: Discussionmentioning
confidence: 99%