Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

W Abdalla  1 , M Elgendy  1 , A A Abdelaziz  1 , M A Ammar  1
Affiliations

Lung ultrasound versus chest radiography for the diagnosis of pneumothorax in critically ill patients: A prospective, single-blind study

W Abdalla et al. Saudi J Anaesth. 2016 Jul-Sep.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Chest radiograph showing right side pneumothorax
Figure 2
Figure 2
Thoracic computed tomography showing right side pneumothorax
Flow Chart 1
Flow Chart 1
The consort E-flow chart
Figure 3
Figure 3
Lung ultrasound showing Seashore sign in a patient without pneumothorax
Figure 4
Figure 4
Lung ultrasound showing barcode sign in a patient with pneumothorax
See this image and copyright information in PMC

References

    1. Strange C. Pleural complications in the Intensive Care Unit. Clin Chest Med. 1999;20:317–27. - PubMed
    1. de Latorre FJ, Tomasa A, Klamburg J, Leon C, Soler M, Rius J. Incidence of pneumothorax and pneumomediastinum in patients with aspiration pneumonia requiring ventilatory support. Chest. 1977;72:141–4. - PubMed
    1. Wilson H, Ellsmere J, Tallon J, Kirkpatrick A. Occult pneumothorax in the blunt trauma patient: Tube thoracostomy or observation? Injury. 2009;40:928–31. - PubMed
    1. Chiles C, Ravin CE. Radiographic recognition of pneumothorax in the Intensive Care Unit. Crit Care Med. 1986;14:677–80. - PubMed
    1. Tocino IM, Miller MH, Fairfax WR. Distribution of pneumothorax in the supine and semirecumbent critically ill adult. AJR Am J Roentgenol. 1985;144:901–5. - PubMed