Lung Ultrasound to Detect Residual Pneumothorax After Chest Drain Removal in Lung Resections

Patella, Miriam; Saporito, Andrea; Puligheddu, Carla; Mongelli, Francesco; Regina, Davide La; Pini, Ramon; Inderbitzi, Rolf; Cafarotti, Stefano

doi:10.1016/j.athoracsur.2017.12.008

Cited by 26 publications

(37 citation statements)

References 24 publications

(37 reference statements)

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“…47 The absence of lung sliding or B-line to diagnose pneumothorax by LUS has a sensitivity of 88% to 100%. 48,49 Our study further con rmed the 90% sensitivity of LUS to diagnose pneumothorax. Because the thorax was opened for VATS, the pneumothorax was deemed residual gas.…”

Section: Discussionsupporting

confidence: 69%

“…Patella et al 48,50 demonstrated that LUS could also effectively and accurately evaluate the small amount of pneumothorax remaining after thoracic drainage, which was faster and more accurate than CXR. Senniappan's study suggested that LUS may be an alternative to CXR for the follow-up of pneumothorax due to its superior sensitivity, portability and reduction in radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and Efficacy of Lung Ultrasound to Investigate Pulmonary Complications in Patients Who Developed Postoperative Hypoxaemia-A Prospective Study

Xie

Sun

You

et al. 2020

Preprint

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Abstract Background: Postoperative pulmonary complications (PPCs) and hypoxaemia are associated with morbidity and mortality. We aimed to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose PPCs in patients suffering from hypoxaemia after general anaesthesia and compare the results to those of thoracic computed tomography (CT). Methods: Adult patients who received general anaesthesia and suffered from hypoxaemia in the postanaesthesia care unit (PACU) were analysed. Hypoxaemia was defined as an oxygen saturation measured by pulse oximetry (SPO2) less than 92% for more than 30 seconds under ambient air conditions. LUS was performed by two trained anaesthesiologists once hypoxaemia occurred. After LUS examination, each patient was transported to the radiology department for thoracic CT scan within 1 hour before returning to the ward. Results: From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopaedic surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) or other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis, while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan, and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%). Conclusions: Lung ultrasound is feasible, efficient and accurate in diagnosing different aetiologies of postoperative hypoxia in healthy-weight patients in the PACU.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Lung Ultrasound to Investigate Pulmonary Complications in Patients Who Developed Postoperative Hypoxaemia-A Prospective Study

Xie

Sun

You

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Because the thorax was opened for VATS, the pneumothorax was deemed residual gas. Patella et al [47,49] demonstrated that LUS could also effectively and accurately evaluate the small amount of pneumothorax remaining after thoracic drainage, which was faster and more accurate than CXR. Senniappan's study suggested that LUS may be an alternative to CXR for the follow-up of pneumothorax due to its superior sensitivity, portability and reduction in radiation exposure [50].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of lung ultrasound to investigate pulmonary complications in patients who developed postoperative Hypoxaemia-a prospective study

et al. 2020

View full text Add to dashboard Cite

Background: Postoperative pulmonary complications (PPCs) and hypoxaemia are associated with morbidity and mortality. We aimed to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose PPCs in patients suffering from hypoxaemia after general anaesthesia and compare the results to those of thoracic computed tomography (CT). Methods: Adult patients who received general anaesthesia and suffered from hypoxaemia in the postanaesthesia care unit (PACU) were analysed. Hypoxaemia was defined as an oxygen saturation measured by pulse oximetry (SPO 2) less than 92% for more than 30 s under ambient air conditions. LUS was performed by two trained anaesthesiologists once hypoxaemia occurred. After LUS examination, each patient was transported to the radiology department for thoracic CT scan within 1 h before returning to the ward. Results: From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopaedic surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) or other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis, while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan, and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%). Conclusions: Lung ultrasound is feasible, efficient and accurate in diagnosing different aetiologies of postoperative hypoxia in healthy-weight patients in the PACU.

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“…in 2% of cases of transhiatal esophagectomy, which has similar surgical steps as in cervical esophageal exclusion. 4 Furthermore, our experience has shown that recanalization from titanium stapling has a variable time course, and recanalization at 2 weeks might not have achieved its objective of exclusion before healing is established. We also found that a full recanalization requires a few endoscopic balloon dilatations.…”

mentioning

confidence: 97%

Transthoracic Ultrasound in Pneumothorax

Tinti

Quarato

Sperandeo

2020

The Annals of Thoracic Surgery

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Lung Ultrasound to Detect Residual Pneumothorax After Chest Drain Removal in Lung Resections

Abstract: In this subgroup of patients with air leak of 10 to 20 mL/min, performing an imaging study to verify the absence of PTx is desirable; however, when LUS confirms lung expansion or the presence of apical PTx, CR does not seem to be needed.

Cited by 26 publications

References 24 publications

Feasibility and Efficacy of Lung Ultrasound to Investigate Pulmonary Complications in Patients Who Developed Postoperative Hypoxaemia-A Prospective Study

Feasibility and Efficacy of Lung Ultrasound to Investigate Pulmonary Complications in Patients Who Developed Postoperative Hypoxaemia-A Prospective Study

Feasibility and efficacy of lung ultrasound to investigate pulmonary complications in patients who developed postoperative Hypoxaemia-a prospective study

Transthoracic Ultrasound in Pneumothorax

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