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Intensive Care Medicine
Published in: Intensive Care Medicine 2/2011

01-02-2011 | Review

Sonographic diagnosis of pneumothorax

Author: Giovanni Volpicelli

Published in: Intensive Care Medicine | Issue 2/2011

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Abstract

Purpose

Over the last decade, the use of ultrasound as a technique to look for pneumothorax has rapidly evolved. This review aims to analyze and synthesize current knowledge on lung ultrasound targeted at the diagnosis of pneumothorax. The technique and its usefulness in different scenarios are explained, and its merits over conventional radiology are highlighted.

Methods

A systematic literature search (1995–2010) was performed, involving PubMed, to describe the more recent scientific evidence on the topic. Moreover, this review is also a synopsis of experts’ opinion and personal clinical experience.

Results and conclusions

Ultrasound diagnosis of pneumothorax relies on the recognition of four sonographic artifact signs: the lung sliding, the B lines, the lung point, and the lung pulse. Combining these few signs, it is possible to accurately rule in or rule out pneumothorax at the bedside in several different clinical scenarios. Sensitivity of a lung ultrasound in the detection of pneumothorax is higher than that of conventional anterior–posterior chest radiography, and similar to that of computerized tomography. A major benefit of a lung ultrasound is that it can be used quickly to diagnose pneumothorax at the bedside in any critical situation, like cardiac arrest and hemodynamically unstable patients. Moreover, it can be used to detect radio-occult pneumothorax and to quantify the extension of the air layer. Advantages in terms of reduced complexity, feasibility at the bedside, and absence of exposure to ionizing radiation make lung ultrasound the method of choice in several common clinical situations.
Appendix
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Metadata
Title
Sonographic diagnosis of pneumothorax
Author
Giovanni Volpicelli
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 2/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-2079-y

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