Saudi J Anaesth. 2016 Jul-Sep;10(3):265-9. doi: 10.4103/1658-354X.174906.
Lung ultrasound versus chest radiography for the diagnosis of pneumothorax in critically ill patients: A prospective, single-blind study.
Saudi journal of anaesthesia
W Abdalla, M Elgendy, A A Abdelaziz, M A Ammar
Affiliations
Affiliations
- Department of Anesthesia, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
PMID: 27375379
PMCID: PMC4916808 DOI: 10.4103/1658-354X.174906
Abstract
BACKGROUND: Radiologic data remains the gold standard for the diagnosis of pneumothorax (PTX). The use of ultrasonography (US) has recently emerged as the method of choice with physicians who can perform bedside US.
PURPOSE: To compare the diagnostic accuracy of lung US against bedside chest radiography (CR) for the detection of PTX using thoracic computed tomography (CT) as the gold standard.
MATERIALS AND METHODS: We conducted a prospective, single-blind study on 192 critically ill patients; each patient received lung US examination, bedside CR, followed by thoracic CT scan searching for PTX.
RESULTS: Of the studied patients, CT of the chest confirmed the diagnosis of PTX in 36 (18.75%) patients of which 31 were diagnosed by thoracic US while CR detected only 19 cases. Overall lung US showed a considerable higher sensitivity than bedside CR (86.1% vs. 52.7%), lung US also showed higher, negative predictive values, and diagnostic accuracy against CR (96.8% vs. 90.1%), and (95.3% vs. 90.6%), respectively. CR had a slightly higher specificity than lung US (99.4% vs. 97.4%), and higher positive predictive values (95.0% vs. 88.6%).
CONCLUSION: Lung US is an accurate modality more than anteroposterior bedside CR in comparison with CT scanning when evaluating critically ill mechanically ventilated patients, patients underwent thoracocentesis, central venous catheter insertion, or patients with polytrauma.
Keywords: Intensive Care Unit; lung ultrasound; mechanical ventilation; pneumothorax
References
- Am J Surg. 2005 May;189(5):541-6; discussion 546 - PubMed
- Crit Care. 2006;10 (4):R112 - PubMed
- Crit Care Med. 2010 Feb;38(2):533-8 - PubMed
- J Trauma. 2011 Feb;70(2):510-8 - PubMed
- AJR Am J Roentgenol. 1985 May;144(5):901-5 - PubMed
- Crit Care Med. 1986 Aug;14 (8):677-80 - PubMed
- Chest. 2004 Mar;125(3):1059-62 - PubMed
- Eur J Radiol. 2005 Mar;53(3):463-70 - PubMed
- Respir Med. 2006 Aug;100(8):1356-9 - PubMed
- Radiology. 2002 Oct;225(1):210-4 - PubMed
- Chest. 2011 Oct;140(4):859-66 - PubMed
- Ultrasound Med Biol. 2006 Aug;32(8):1157-63 - PubMed
- Chest. 2008 Jan;133(1):204-11 - PubMed
- J Ultrasound Med. 2009 Jun;28(6):749-55 - PubMed
- Clin Chest Med. 1999 Jun;20(2):317-27 - PubMed
- Radiol Med. 2006 Jun;111(4):516-25 - PubMed
- Chest. 1977 Aug;72(2):141-4 - PubMed
- Eur Radiol. 2005 May;15(5):930-5 - PubMed
- Acad Emerg Med. 2005 Sep;12 (9):844-9 - PubMed
- Injury. 2009 Sep;40(9):928-31 - PubMed
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