A practical guide to transthoracic ultrasound

Groote-Bidlingmaier, Florian von; Koegelenberg, Coenraad F.N.

doi:10.1183/20734735.024112

Cited by 13 publications

(16 citation statements)

References 46 publications

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“…Failure of thoracentesis and/or drainage requires surgical treatment in selected patients. Results of this study concerning success rate of thoracentesis and drainage are in accordance with analyzed data that reported success rate from 62% to 97% depending on the echo structure of collection [ 11 , 16 , 23 ]. Preprocedural US can predict the likelihood of success of thoracentesis or drainage but not the patient outcome.…”

Section: Discussionsupporting

confidence: 89%

“…This study and literature data confirmed that existence of intrapleural septa may predict a more complicated clinical course [ 6 , 8 – 10 , 15 – 20 ]. Our results and reported series show that the smaller number of complications and high success rate of thoracentesis even in complex loculated collections can be explained by the particular choice of the point of puncture in the skin mark-based method and the constant view and following of the needle during the real-time US-guided intervention [ 13 , 14 , 16 , 21 , 22 , 23 , 24 , 25 ]. Cases with small or thick fluid collection (solid-like appearance) with the complex echo structure and thick septations were evaluated as nondrainable, so inefficient chest tube placement with possible complications has been avoided [ 10 , 18 , 26 ].…”

Section: Discussionmentioning

confidence: 78%

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Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion

Stevic

Čolić

Bascarevic

et al. 2018

Canadian Respiratory Journal

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Aim The aim of this study was to evaluate the role of thoracic sonography in treatment of pleural effusions and to identify sonographic indicators for surgical intervention. Materials and Methods This study included 378 patients with pleural effusions. US characteristics of effusions as the echo structure and pleural thickening were analyzed. Regarding the US finding, the diagnostic or therapeutic procedure was performed. Results The study included 267 male and 111 female patients, an average of 56.7 years. Infection was the most frequent cause of effusion. Two hundred sixty-nine patients had loculated and 109 free pleural effusion. Most frequent echo structure of loculated effusion was complex septate, whereas free effusion was mostly anechoic. Successful obtaining of the pleural fluid without real-time guidance was in 88% and under real-time guidance in 99% patients (p < 0.012). There was no significant difference in success rate between free and loculated effusion and regarding the echo structure (p=0.710 and 0.126, respectively). Complete fluid removal after serial thoracentesis or drainage was achieved in 86% patients. Forty-five patients with significantly thicker pleural peel and impairment of the diaphragmatic function than remaining of the group (p < 0.001) underwent surgery. Open thoracotomy and decortication was more frequently performed in patients with completely fixed diaphragm and complex, dominantly septated effusions. There is no significant difference in US parameters comparing to patients underwent VATS, but the number of VATS is too small for valid conclusion. Conclusion Thoracic sonography is a very useful tool in the evaluation of clinical course and treatment options in patients with pleural effusions of a different origin.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 78%

Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion

Stevic

Čolić

Bascarevic

et al. 2018

Canadian Respiratory Journal

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“…Different authors have estimated the normal values of PLT in TN: Copetti et al 6 defined “pleural line abnormality” as “thickening greater than 0.5 mm…”; Liu et al used the term “abnormal pleural line” to those thicker in width more than 0.5 cm 11 or less than 0.5 mm in another publications 12,13 . Studies in adults use the value of 2 mm 14 or 2.5 mm as a definition of normal PLT 15 . These approaches are not based on published results, but on the personal experience of the authors.…”

Section: Discussionmentioning

confidence: 99%

Pleural line thickness reference values for preterm and term newborns

Alonso‐Ojembarrena

Ruiz-González

González-Haba-Martínez

et al. 2020

Pediatric Pulmonology

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Background In lung ultrasound (LUS), the pleural line is an artifact whose thickness depends on the underlying lung pathology. To date there are no published studies on normal values of pleural line thickness (PLT) in newborns. Objective The aim of our study is to describe normal PLT values in term newborn (TN) and preterm newborn (PTN). Methods We recruited eupneic TN and PTN, under 34 weeks of gestation, on their first 24 hours of life. Newborns presenting any respiratory distress since birth were excluded. LUS was performed in four areas: upper anterior, lower anterior, lateral and posterior. At each location, we measured PLT and values where compared. Intraobserver and interobserver agreement were assessed using the intraclass correlation coefficient (ICC), and the kappa coefficient. Results We included 23 TN with a median birth weight of 3365 g (interquartile range [IQR] 3100‐3575 g) and a median gestational age of 39 weeks (IQR, 38‐40 weeks). In the PTN group, 23 patients were included with a median birth weight of 1350 g (IQR, 1150‐1590 g) and a median gestational age of 31 weeks (IQR, 30‐32 weeks). Median PLT values were less than 1 mm, and there were no significant differences between groups at any locations, with the exception of the left lower anterior field (0.79 mm [IQR, 0.72‐0.89 mm] vs 0.68 mm [IQR, 0.62‐0.72 mm]). Intraobserver agreement was high: consistency ICC 0.77 (95% confidence interval [CI], 0.32‐0.92) and absolute ICC 0.78 (95% CI, 0.34‐0.93). Interobserver agreement was high for the definition of thin pleural line as less than 1 mm. Conclusions TN and asymptomatic PTN have similar PLT values. Overall, PLT in healthy newborns should be less than 1 mm.

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“…Nevertheless, these qualities have not led to the use of US at its maximum potential [1,[3][4][5]. US allows exploration of the pleura, pericardium, spleen, abdominal cavity, lymph nodes (simultaneously affected, suggests TBC) and it is superior to pulmonary X-ray in assessing lung changes over time, in response to therapy [1,6].…”

Section: Discussionmentioning

confidence: 99%

“…Irregular pleural thickening and effusions, as well as infiltration of adjacent structures, represent US aspects of pleural malignant tumors [2,12,14]. TUS indications are represented by qualitative/quantitative description and identification of minimal localized pleural effusions (more sensitive than x-ray), highlighting chest wall tumors, guiding safe performance of thoracocentesis, aspiration, biopsy of lung infiltrations/nodules/abscesses [5,6,15]. The efficiency depends on examination protocol: 3.5-5 MHz transducers are used for rapid identification of pathological aspects, but sometimes a higher frequency transducer (7.5-13 MHz) is required [2].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound as the first imaging method in severe lung disease. Considerations about a case of pulmonary tuberculosis and review of the literature

et al. 2020

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Abdominal ultrasound (US) performed as a “primary imaging procedure” is an important diagnostic tool in gastroenterol-ogy. Expanding the routine investigation to the lower thoracic region might sometimes accelerate the diagnosis in inconclusive manifestations such as pulmonary pathology.US is a valuable tool in evaluating patients with breathing difficulties, chest pain, hypoxia, or chest trauma. This paper presents the particular situation of a patient hospitalized in the gastroenterology depart-ment, where the US identified significant pulmonary alterations and changed the final diagnosis from a gastrointestinal disease to pleuro-pulmonary tuberculosis. A brief review of literature is also included, in relation to chest US.

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A practical guide to transthoracic ultrasound

Cited by 13 publications

References 46 publications

Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion

Sonographic Indicators for Treatment Choice and Follow-Up in Patients with Pleural Effusion

Pleural line thickness reference values for preterm and term newborns

Ultrasound as the first imaging method in severe lung disease. Considerations about a case of pulmonary tuberculosis and review of the literature

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