Ultrasound diagnosis of pneumothorax

Garofalo, G.; Busso, Marco; Perotto, F.; Pascale, A. De; Fava, Cesare

doi:10.1007/s11547-006-0047-y

Cited by 51 publications

(34 citation statements)

References 16 publications

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“…22 Another study, found also higher numbers in chest ultrasound sensitivity in detecting pneumothorax 95.5%, 100% specificity and diagnostic accuracy about 98.9%. 26 lower number were found on one point probing chest ultrasound that was examining only the 3rd intercostal space, midclavicular line for detection of pneumothorax found sensitivity of 92% and specificity of 78% which is lower than our results. 27 Study couldn't detect lung point be in six patients with pneumothorax and this is due to the position of such points were different from the position of the four points of BLUE protocol.…”

Section: Discussioncontrasting

confidence: 90%

Role of bedside sonography in the assessment of patients with chest trauma in the emergency department of Suez Canal University Hospital

et al. 2017

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Background: Chest trauma is responsible for more than 20 to 25% of all traumatic death. Chest trauma is the second leading cause of traumatic death in each year. In order to keep the prognosis of patients with chest trauma relatively good, the patient should be diagnosed rapidly & managed adequately. Chest ultrasound is a safe, rapid and accurate method in diagnosing chest trauma.Methods: A total of 50 patients were enrolled in this study. Objectives were to assess the accuracy of bedside chest US in detection of either haemothorax, pneumothorax or lung contusion in chest trauma patients. All the patients underwent chest US, CXR, and chest CT. The data from ultrasound and CXR were compared with the gold standard CT. Then the accuracy of which were calculated.Results: Showed that Motorcar accidents are the most common cause for chest trauma and most patients were presented by chest pain and dyspnea. Chest ultrasound specificity in diagnosing pneumothorax was higher than sensitivity, 100% and 81% respectively, with over all accuracy 88%. Supine CXR showed sensitivity (75%), specificity (88.9%) and accuracy (80%) which are good numbers but still lower than chest US. Chest US Detection of haemothorax by chest had showed 100% sensitivity, 90% specificity and 96% accuracy.Conclusions: Chest ultrasound is highly accurate tool for detection of pneumothorax, haemothorax and less lung contusion in chest trauma. Chest ultrasound is a useful tool for the emergency physician for bedside rapid and accurate diagnosis without interruption of the resuscitation and without transferring the patient for the radiology unit.

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Section: Discussioncontrasting

confidence: 90%

Role of bedside sonography in the assessment of patients with chest trauma in the emergency department of Suez Canal University Hospital

et al. 2017

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“…29 In fact, the author who performed 77 procedures had a Se and Sp that were higher than clinicians performing o14 examinations; with comparable Se and Sp (490%) to US-diagnosed PTX in human studies. 1,15,16,27,[36][37][38][39][40] Techniques to reduce the difficulty in developing proficiency have been evaluated in the human literature. Use of adjunctive US modalities such as M-mode and power Doppler are suggested to be helpful in diagnosing PTX.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4]14,[16][17][18]27,28,[31][32][33][34][35] Using computerized tomography (CT) as the gold standard, reports have documented the reliability of thoracic US to diagnose PTX in humans. 1,16,18,19,27 Moreover, human studies have shown thoracic US to be comparable in specificity (94% versus 100%) and superior in sensitivity (88-100% versus 36%-75%) to supine survey CXR, 1,15,16,27,[36][37][38][39][40] with CXR missing 30-50% of radiographically occult pneumothoraces. [14][15][16][17]40 US has been dubbed an 'extension of the physical exam' regarding intrathoracic fluid, in human critical care and trauma settings, because of its high sensitivity and specificity in detecting pleural and pericardial fluid compared with physical examination and CXR findings.…”

Section: Introductionmentioning

confidence: 99%

“…1,4,17,19,21,36,37,48 'Comet tail artifacts' or 'lung rockets', created by abnormalities within the lung parenchyma, have likewise been used to exclude PTX in human and veterinary patients since their presence cannot be observed with free air (PTX) in the pleural space. 1,17,19,23,36,47,[49][50][51]55 The US diagnosis of PTX has been affirmed in porcine research models 2,3,49 and in numerous recent studies in traumatized humans evaluating US, CXR, and CT findings, 1,16,18,19,27,[36][37][38][39][40] but not clinically in traumatized dogs or cats. Furthermore, lack of widespread availability, cost, and requirement of general anesthesia, make CT problematic in its use for imaging traumatized dogs and cats.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a thoracic focused assessment with sonography for trauma (TFAST) protocol to detect pneumothorax and concurrent thoracic injury in 145 traumatized dogs

Lisciandro¹,

Lagutchik²,

Mann³

et al. 2008

J Vet Emergen Crit Care

116

132

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Objective: To estimate the relative accuracy of a thoracic focused assessment with sonography for trauma (TFAST) protocol for rapid diagnosis of pneumothorax (PTX) and other thoracic injury in traumatized dogs. Design: Prospective case series. Setting: Private veterinary emergency center. Animals: One hundred and forty-five client-owned dogs evaluated within 24-hours of injury. Interventions: Thoracic focused assessment with sonography for trauma protocol. Measurements and Main Results: Traumatized dogs were evaluated with a conventional ultrasound (US) machine using a standardized 4-point thoracic FAST protocol before thoracic radiography (CXR) and thoracocentesis. PTX was diagnosed by the absence of the 'glide sign,' defined as the lack of the normal dynamic interface between lung margins gliding along the thoracic wall during respiration. Concurrent thoracic trauma was diagnosed by the presence of pleural or pericardial fluid or the presence of a 'step sign,' defined as an abnormal glide sign. Accuracy of TFAST was calculated relative to CXR findings. Results: Overall sensitivity (Se), specificity (Sp), and accuracy of TFAST relative to CXR were 78.1% (95% CI; 61.5, 89.9), 93.4% (95% CI; 87.4, 97.1), and 90.0%, respectively. Se and Sp were higher in dogs with penetrating trauma (93.3%, 96.0%) and for the evaluator with the most clinical experience (95.2%, 96.0%); only Se between the most experienced compared with others was statistically significant (Po0.05). TFAST documented other concurrent thoracic injury. Median time for TFAST was 3 minutes. Conclusions and Clinical Relevance: TFAST has the potential to rapidly diagnose PTX and other thoracic injury and guide therapy, including potentially life-saving interventions, in traumatized dogs.

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“…There are B mode signs and also an M mode sign. The classical ultrasonographical signs of pneumothorax are absence of lung sliding, of B lines and lung pulse, and presence of lung point [13][14][15][16]. In M mode normal aspect of "sea shore" corresponding to peripheral aerated lung is replaced with the "stratosphere" sign where the pneumothorax is present [17,18].…”

Section: Pleural Pathologymentioning

confidence: 99%

Pleural ultrasonography. Pictorial essay.

Chira

et al. 2014

Med Ultrason

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Pleural ultrasonography (US) represents nowadays a useful diagnostic tool in the management of pleural diseases. Detection and evaluation of pleural effusions, pneumothorax and pleural-based lesions can be performed with US, which has the advantages of wide availability, low cost, absence of radiation exposure, and portability. It is the best method for guiding interventional procedures in the pleural space. It has also limitations, due to the interposition of bony parts of the thorax, subcutaneous emphysema and inability to visualize the mediastinal pleura. US of the thorax is an operator dependent technique demanding an experienced operator in order to obtain reliable results. This pictorial essay presents various ultrasound findings of the diseases which concern the pleura.

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Ultrasound diagnosis of pneumothorax

Abstract: Chest US was found to be a valuable diagnostic tool in pneumothorax diagnosis, with diagnostic effectiveness well beyond X-rays and similar to CT.

Cited by 51 publications

References 16 publications

Role of bedside sonography in the assessment of patients with chest trauma in the emergency department of Suez Canal University Hospital

Role of bedside sonography in the assessment of patients with chest trauma in the emergency department of Suez Canal University Hospital

Evaluation of a thoracic focused assessment with sonography for trauma (TFAST) protocol to detect pneumothorax and concurrent thoracic injury in 145 traumatized dogs

Pleural ultrasonography. Pictorial essay.

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