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Intensive Care Medicine
Published in: Intensive Care Medicine 10/2014

01-10-2014 | Original

Semi-quantification of pneumothorax volume by lung ultrasound

Authors: Giovanni Volpicelli, Enrico Boero, Nicola Sverzellati, Luciano Cardinale, Marco Busso, Francesco Boccuzzi, Mattia Tullio, Alessandro Lamorte, Valerio Stefanone, Giovanni Ferrari, Andrea Veltri, Mauro F. Frascisco

Published in: Intensive Care Medicine | Issue 10/2014

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Abstract

Background

Lung ultrasound (LUS) may accurately diagnose pneumothorax. However, there is uncertainty about its usefulness in the quantification of pneumothorax size. To determine the ability of LUS in the semi-quantification of pneumothorax volume, we compared the projection of the lung point (LP) with the pneumothorax volume measured by computerized tomography (CT) and the interpleural distance on chest radiography (CXR).

Methods

We performed LUS in patients with pneumothorax and all the LP located on the chest wall were compared to CXR and CT studies. The primary outcome of the study was the ability of LP to grade pneumothorax volumes measured by CT. The secondary outcome was the accuracy of LP to predict small and large pneumothorax according to the societal guidelines based on CXR reading.

Results

A total of 124 patients with pneumothorax were enrolled (76 spontaneous, 20 traumatic and 28 post-procedural). Ninety-four CXR and 58 CT were available for the analysis. An LP posterior to the mid axillary line corresponded to three different CXR criteria for large pneumothorax with sensitivity from 81.4 to 88.2 % and specificity from 64.7 to 72.6 %. The mid axillary line also represented the limit for predicting greater than 15 % of lung collapse when volume is measured at CT, with sensitivity 83.3 % and specificity 82.4 %.

Conclusions

LUS-targeted assessment of LP was a useful predictor of pneumothorax volume in this research study setting. LUS reliably classified pneumothorax size when compared to criteria based on CXR reading, particularly the small sized pneumothorax. However, LUS greatly outperformed conventional CXR reading for a graded quantification of the percentage of lung collapse.
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Metadata
Title
Semi-quantification of pneumothorax volume by lung ultrasound
Authors
Giovanni Volpicelli
Enrico Boero
Nicola Sverzellati
Luciano Cardinale
Marco Busso
Francesco Boccuzzi
Mattia Tullio
Alessandro Lamorte
Valerio Stefanone
Giovanni Ferrari
Andrea Veltri
Mauro F. Frascisco
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 10/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-014-3402-9

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