Document Detail


Using thoracic ultrasonography to accurately assess pneumothorax progression during positive pressure ventilation: a comparison with CT scanning.
MedLine Citation:
PMID:  23188058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although thoracic ultrasonography accurately determines the size and extent of occult pneumothoraces (PTXs) in spontaneously breathing patients, there is uncertainty about patients receiving positive pressure ventilation. We compared the lung point (ie, the area where the collapsed lung still adheres to the inside of the chest wall) using the two modalities ultrasonography and CT scanning to determine whether ultrasonography can be used reliably to assess PTX progression in a positive-pressure-ventilated porcine model.
METHODS: Air was introduced in incremental steps into fi ve hemithoraces in three intubated porcine models. The lung point was identified on ultrasound imaging and referenced against the lateral limit of the intrapleural air space identified on the CT scans. The distance from the sternum to the lung point (S-LP) was measured on the CT scans and correlated to the insufflated air volume.
RESULTS: The mean total difference between the 131 ultrasound and CT scan lung points was 6.8 mm (SD, 7.1 mm; range, 0.0-29.3 mm). A mixed-model regression analysis showed a linear relationship between the S-LP distances and the PTX volume ( P , .001).
CONCLUSIONS: In an experimental porcine model, we found a linear relation between the PTX size and the lateral position of the lung point. The accuracy of thoracic ultrasonography for identifying the lung point (and, thus, the PTX extent) was comparable to that of CT imaging. These clinically relevant results suggest that ultrasonography may be safe and accurate in monitoring PTX progression during positive pressure ventilation.
Authors:
Nils Petter Oveland; Hans Morten Lossius; Kristian Wemmelund; Paal Johan Stokkeland; Lars Knudsen; Erik Sloth
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  143     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-06-20     Revised Date:  2013-07-24    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  415-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Research and Development, Norwegian Air Ambulance Foundation, Droebak, Norway. nils.petter.oveland@norskluftambulanse.no
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MeSH Terms
Descriptor/Qualifier:
Animals
Disease Progression*
Female
Lung / radiography,  ultrasonography
Models, Animal
Pneumothorax / radiography*,  ultrasonography*
Positive-Pressure Respiration*
Regression Analysis
Reproducibility of Results
Swine
Thoracic Wall / radiography,  ultrasonography
Tomography, X-Ray Computed / methods*
Ultrasonography / methods*
Comments/Corrections
Comment In:
Chest. 2013 Jun;143(6):1838-9   [PMID:  23732609 ]
Chest. 2013 Jun;143(6):1837-8   [PMID:  23732608 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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