Subpleural artifact in lung pulse evidenced by M-mode ultrasound in a patient with atelectasis

Gómez-Casero, R. Blancas; Fernández, M Á Alonso; Ballesteros-Ortega, D.; González, Oscar M.

doi:10.1016/j.redar.2014.12.010

Cited by 3 publications

(4 citation statements)

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“…The phenomenon was explained by a better transmission of heart beats through the atelectatic lung. The lung pulse has also been observed in the M-mode chest ultrasonography in patients with pleural effusion and atelectatic lung [4][5][6][7]. On the basis of our observations, we propose that pleural manometry could be a more sensitive and more accurate measure of pleural pulsations, albeit more invasive, than the M-mode US imaging.…”

Section: Discussionsupporting

confidence: 62%

“…It has been demonstrated that heart cyclic contractions generate blood flow in large vessels and can also interact with adjacent organs by passing on pulsations. This is exemplified by the so-called "lung pulse" which was first described as an early ultrasound sign of complete lung atelectasis [3], and later, also reported in patients with pleural effusion [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Pleural Pressure Pulse in Patients with Pleural Effusion: A New Phenomenon Registered during Thoracentesis with Pleural Manometry

Grabczak

Michnikowski

Styczyński

et al. 2020

JCM

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Pleural manometry enables the assessment of physiological abnormalities of lung mechanics associated with pleural effusion. Applying pleural manometry, we found small pleural pressure curve oscillations resembling the pulse tracing line. The aim of our study was to characterize the oscillations of pleural pressure curve (termed here as the pleural pressure pulse, PPP) and to establish their origin and potential significance. This was an observational cross-sectional study in adult patients with pleural effusion who underwent thoracentesis with pleural manometry. The pleural pressure curves recorded prior to and during fluid withdrawal were analyzed. The presence of PPP was assessed in relation to the withdrawn pleural fluid volume, lung expandability, vital and echocardiographic parameters, and pulmonary function testing. A dedicated device was developed to compare the PPP to the pulse rate. Fifty-four patients (32 women) median age 66.5 (IQR 58.5–78.7) years were included. Well visible and poorly visible pressure waves were detected in 48% and 35% of the patients, respectively. The frequency of PPP was fully concordant with the pulse rate and the peaks of the oscillations reflected the period of heart diastole. PPP was more visible in patients with a slower respiratory rate (p = 0.008), a larger amount of pleural effusion, and was associated with a better heart systolic function assessed by echocardiography (p < 0.05). This study describes a PPP, a new pleural phenomenon related to the cyclic changes in the heart chambers volume. Although the importance of PPP remains largely unknown, we hypothesize that it could be related to lung atelectasis or lower lung and visceral pleura compliance.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Pleural Pressure Pulse in Patients with Pleural Effusion: A New Phenomenon Registered during Thoracentesis with Pleural Manometry

Grabczak

Michnikowski

Styczyński

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Due to advantages such as simplicity, convenience, time requirement and non-radiation, LUS can be performed multiple times at the bedside. The sensitivity and specificity of the diagnosis of atelectasis by lung pulse in ultrasound were 93 and 100%, respectively [ 32 , 33 ]. When compared with magnetic resonance imaging (MRI), LUS showed a sensitivity of 88%, specificity of 89% and accuracy of 88% in diagnosing pulmonary atelectasis [ 10 ].…”

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

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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 the affected area, the air artifacts are not visible (lines A absent), and the lung appears as a parenchymatous-like structure with high density. The normal pleural sliding is abolished, and the "lung pulse" can be highlighted, i.e., the pulsation of the pleural line synchronous with cardiac activity [29].…”

Section: Pneumoniamentioning

confidence: 99%

Point-of-Care Thoracic Ultrasound in Children: New Advances in Pediatric Emergency Setting

et al. 2023

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Point-of-care thoracic ultrasound at the patient’s bedside has increased significantly recently, especially in pediatric settings. Its low cost, rapidity, simplicity, and repeatability make it a practical examination to guide diagnosis and treatment choices, especially in pediatric emergency departments. The fields of application of this innovative imaging method are many and include primarily the study of lungs but also that of the heart, diaphragm, and vessels. This manuscript aims to describe the most important evidence for using thoracic ultrasound in the pediatric emergency setting.

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Subpleural artifact in lung pulse evidenced by M-mode ultrasound in a patient with atelectasis

Cited by 3 publications

References 0 publications

Pleural Pressure Pulse in Patients with Pleural Effusion: A New Phenomenon Registered during Thoracentesis with Pleural Manometry

Pleural Pressure Pulse in Patients with Pleural Effusion: A New Phenomenon Registered during Thoracentesis with Pleural Manometry

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

Point-of-Care Thoracic Ultrasound in Children: New Advances in Pediatric Emergency Setting

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