Quantification of the Size of Primary Spontaneous Pneumothorax: Accuracy of the Light Index

Abstract

Background: The size of a pneumothorax (PTX) is usually estimated by the Light index. Treatment strategies of (primary, spontaneous) PTX partially depend upon the size of the PTX. To our knowledge, the Light index has not yet been correlated with the actual volume of the PTX. Objectives: To correlate the estimated size of a primary spontaneous PTX by means of the Light index, with the actual amount of air present in the pleural space. Methods: Actual PTX volumes were measured by means of manual aspiration of air present in the pleural space in 18 patients with primary spontaneous PTX and correlated with the size estimation obtained by the Light index. Results: Light index and volume measurements were strongly correlated (r = 0.84, p < 0.0001). Conclusions: The Light index is a good estimate of the actual size of a (primary spontaneous) PTX.

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

“…The Task Force was established according to the recommendations of the ERS Scientific Committee for development of a statement that is a comprehensive scientific review by a group of experts (table 1). The statement is based on a body of scientific evidence identified by systematic searches and documented by references supporting the conclusions [18]. Initially, a set of key clinical questions in five sections was formulated on epidemiology, diagnosis, classification, treatment of first episode and treatment of recurrent or complicated PSP.…”

“…A study used this method and found a strong correlation between the estimated size and the volume of air removed from the pleural space during drainage [18]. However, a comparison between the estimated size of a pneumothorax using the Light index and CT volumetrics, derived by the Collins method, found poor agreement between the methods [72].…”

Spontaneous pneumothorax: epidemiology, pathophysiology and cause

“…Diagnosis can be confirmed in the majority of cases on an upright posteroanterior (PA) chest radiograph, which also allows an estimation of the pneumothorax size with good accuracy [9]. In cases with a small PSP, computed tomography (CT) may be necessary to diagnose the presence of pleural air.…”

Iatrogenic pneumothorax related to mechanical ventilation

“…Mediastinal emphysema was the initial manifestation of extra-alveolar air [1] . Although an erect posteroanterior chest radiograph may help to estimate the pneumothorax size [48] , it is not practical in critical illness. However, the supine anteroposterior chest radiographs are available in the ICU, although the appearances of a pneumothorax on a supine radiograph may be different from the classic appearances on an erect radiograph.…”