Ultrasonography Versus Chest Radiography After Chest Tube Removal for the Detection of Pneumothorax

Saucier, Sandra; Motyka, Carrie; Killu, Keith

doi:10.4037/15597768-2010-1005

Cited by 3 publications

(7 citation statements)

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“…A notable exception was reported from Henry Ford Hospital, noting complete agreement (kappa = 1.0) between ultrasound of the supine chest versus CXR (posture unstated) for detecting PTXs after TT removal, leading the authors to conclude that this would be costsaving. 14 It is notable that the examiners who attended the patient's bedside each had greater than 300 examinations prior to the study, whereas our bedside practitioners were novices. We hypothesized that if an ultrasound expert could mentor novice bedside personal that patient safety could be maintained and yet consume fewer resources.…”

Section: Introductionmentioning

confidence: 99%

Just-in-Time Cost-Effective Off-the-Shelf Remote Telementoring of Paramedical Personnel in Bedside Lung Sonography—A Technical Case Study

Biegler

McBeth

Tevez-Molina

et al. 2012

Telemedicine and e-Health

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Section: Introductionmentioning

confidence: 99%

Just-in-Time Cost-Effective Off-the-Shelf Remote Telementoring of Paramedical Personnel in Bedside Lung Sonography—A Technical Case Study

Biegler

McBeth

Tevez-Molina

et al. 2012

Telemedicine and e-Health

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“…There is a strong association between ultrasound and chest X‐ray with a therapeutic agreement of 97% 21 . There is perfect agreement between the two methods with a κ statistics value of 1.000 15 …”

Section: Resultsmentioning

confidence: 90%

“…After the full‐text screening, 18 studies were included in the systematic review. Eleven studies were conducted in the United States of America, 1–3,7,10–16 four studies in the United Kingdom, 17–20 one in the Netherlands, 5 one in Germany, 21 and one in Iran 6 (Table 1). No other studies were identified through manual screening of references of the included studies and relevant reviews.…”

Section: Resultsmentioning

confidence: 99%

“…There are two prospective observational studies with combined 173 patients, which evaluated the role of bedside ultrasound in comparison to using chest X‐ray after removal of a chest drain to detect pneumothorax, predominantly in the thoracic adult surgical population 15,21 . The overall sensitivity of the bedside ultrasound is 32%, however, the sensitivity is increased to 100% in detecting pneumothoraces of 3 cm or larger, and the specificity is 85% 21 .…”

Section: Resultsmentioning

confidence: 99%

“…It is safe, has no ionizing radiation, has lower cost compared with X‐rays, and has rapid instant interpretation compared with ordering, obtaining, and interpreting a chest X‐ray. It is reproducible and requires minimum experience to detect pneumothorax, with the benefit of detecting further diagnoses such as pleural effusion and pericardial effusion 15 . Yet, the use of ultrasound could be limited by subjective interpretation of findings depending on the experience of the operator, postoperative surgical dressings, and anatomical and physiological changes, especially after thoracic surgery.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of chest X‐rays after drain removal in adult and pediatric patients undergoing cardiac and thoracic surgery: A systematic review

Thet

Han

Hlwar

et al. 2022

Journal of Cardiac Surgery

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Background: Chest X-rays are routinely obtained after the removal of chest drains in patients undergoing cardiac and thoracic surgical procedures. However, a lack of guidelines and evidence could question the practice. Routine chest X-rays increase exposure to ionizing radiation, increase health-care costs, and lead to overutilisation of available resources. This review aims to explore the evidence in the literature regarding the routine use of chest X-rays following the removal of chest drains. Materials & Method:A systematic literature search was conducted in PubMed, Medline via Ovid, Cochrane central register of control trials (CENTRAL), and ClinicalTrials. gov without any limit on the publication year. The references of the included studies are manually screened to identify potentially eligible studies.Results: A total of 375 studies were retrieved through the search and 18 studies were included in the review. Incidence of pneumothorax remains less than 10% across adult cardiac, and pediatric cardiac and thoracic surgical populations. The incidence may be as high as 50% in adult thoracic surgical patients. However, the reintervention rate remains less than 2% across the populations. Development of respiratory and cardiovascular symptoms can adequately guide for a chest X-ray following the drain removal. As an alternative, bedside ultrasound can be used to detect pneumothorax in the thorax after the removal of a chest drain without the need for ionizing radiation. Conclusion:A routine chest X-ray following chest drain removal in adult and pediatric patients undergoing cardiac and thoracic surgery is not necessary. It can be omitted without compromising patient safety. Obtaining a chest X-ray should be clinically guided. Alternatively, bedside ultrasound can be used for the same purpose without the need for radiation exposure.

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ERS statement on chest imaging in acute respiratory failure

et al. 2019

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Chest imaging in patients with acute respiratory failure plays an important role in diagnosing, monitoring and assessing the underlying disease. The available modalities range from plain chest X-ray to computed tomography, lung ultrasound, electrical impedance tomography and positron emission tomography. Surprisingly, there are presently no clear-cut recommendations for critical care physicians regarding indications for and limitations of these different techniques.The purpose of the present European Respiratory Society (ERS) statement is to provide physicians with a comprehensive clinical review of chest imaging techniques for the assessment of patients with acute respiratory failure, based on the scientific evidence as identified by systematic searches. For each of these imaging techniques, the panel evaluated the following items: possible indications, technical aspects, qualitative and quantitative analysis of lung morphology and the potential interplay with mechanical ventilation. A systematic search of the literature was performed from inception to September 2018. A first search provided 1833 references. After evaluating the full text and discussion among the committee, 135 references were used to prepare the current statement.These chest imaging techniques allow a better assessment and understanding of the pathogenesis and pathophysiology of patients with acute respiratory failure, but have different indications and can provide additional information to each other.

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Ultrasonography Versus Chest Radiography After Chest Tube Removal for the Detection of Pneumothorax

Abstract: Bedside ultrasound technology is as accurate as chest radiography in detecting pneumothorax following chest tube removal and can save institutions' time and money.

Cited by 3 publications

References 0 publications

Just-in-Time Cost-Effective Off-the-Shelf Remote Telementoring of Paramedical Personnel in Bedside Lung Sonography—A Technical Case Study

Just-in-Time Cost-Effective Off-the-Shelf Remote Telementoring of Paramedical Personnel in Bedside Lung Sonography—A Technical Case Study

Efficacy of chest X‐rays after drain removal in adult and pediatric patients undergoing cardiac and thoracic surgery: A systematic review

ERS statement on chest imaging in acute respiratory failure

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