Ultrasound estimation of volume of pleural fluid in mechanically ventilated patients

Borggrefe, Martin; Plasil, P; Waldauf, Petr; Pazout, J; Fric, Michal; Otáhal, Michal; Pachl, Jan

doi:10.1007/s00134-005-0024-2

Cited by 296 publications

(205 citation statements)

References 17 publications

(24 reference statements)

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“…It is measured with the patient in the supine position by moving the probe from the diaphragm upward along the posterior axillary line to design a cross-section perpendicular to the longitudinal axis of the body from the base of the lung, where the separation between the two pleurae is visible. In this study, a significant correlation was found between ''Sep'' and the amount of pleural fluid evacuated at thoracentesis with a success rate of 100 % and a mean prediction error of 158.4 ± 160.6 ml [39]. US can distinguish between transudates (anechoic) and exudates (echoic and loculated) and is also increasingly used to guide bedside thoracentesis and thoracostomy.…”

Section: Hemothoraxmentioning

confidence: 73%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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Objectives The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients. Methods A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles. Results 80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients. Conclusions US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions. Keywords Trauma Á Ultrasound Á Ultrasound findings Á Ultrasound techniqueRiassunto Obiettivi L'obiettivo di questa ricerca è di presentare la visione e le opinioni correnti sul ruolo dell'ecografia nella gestione del paziente con politrauma. L'articolo è diviso in due parti: nella prima ('Semeiotica ecografica e tecnica di esecuzione dell'esame') verrà data attenzione agli aspetti prevalentemente tecnici dell'ecografia nel trauma, con intento anche didattico; nella seconda (Fisiopatologia e ecografia clinica del trauma) sarà esplorato il tema dell'integrazione dell'ecografia con la clinica e la fisiopatologia nella gestione del politraumatizzato. Metodi Revisione non sistematica della letteratura. Ricerca su PubMed (restrizione agli ultimi 10 anni) di articoli originali e revisioni. Risultati Per la Parte prima sono stati selezionati 80 articoli, tra i quali sono stati scelti con criteri personali quelli ritenuti innovativi o originali nei contenuti (48 articoli originali, 2 revisioni di letteratura). 19 articoli sono stati estratti dalla bibliografia delle pubblicazioni prescelte. I contenuti estratti dai 69 articoli sono stati organizzati in paragrafi intitolati ai singoli ambiti di applicazione dell'ecografia nel politrauma. Conclusioni L'ecografia del trauma è evoluta dalla iniziale applicazione nella diagnosi precoce del versamento peritoneale (Focused Abdominal Sonography for Trauma o FAST) all'accezione più ampia di Resuscitative Ultrasonography (RUS) e v...

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Section: Hemothoraxmentioning

confidence: 73%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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“…In this study, an equation was described between the volume of the effusion and the separation distance between the lung and the outer parietal pleura as the effusion size (cc) = 20 × separation (sep) in mm, where the separation (sep) was identified as the maximal separation distance between the parietal and visceral pleura during end-expiration. In this study, a lower frequency probe was used [13].…”

Section: Indications For Chest Ultrasound: Evaluation Of Pleural Effumentioning

confidence: 99%

“…In contrast, the pneumothorax rate associated with ultrasound-guided thoracenteses was lower, ranging from 0 to 9.1%. The rates of subsequent chest tube insertion for pneumothoraces ranged from 2.2-7% in those procedures without ultrasound guidance and 0-3.7% in procedures performed with ultrasound guidance [6,13,22,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

Section: Overall Incidence Of Pneumothorax and Impact Of Ultrasoundmentioning

confidence: 99%

Ultrasound for the Detection of Pleural Effusions and Guidance of the Thoracentesis Procedure

Sikora

Perera

Mailhot

et al. 2012

ISRN Emergency Medicine

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Objective. To review the use of ultrasound for the detection of pleural effusions and guidance of the thoracentesis procedure. Methods. Two clinical cases will be presented in which ultrasound proved beneficial in guiding the diagnosis and management of patients with pleural effusions and respiratory distress. The ultrasound techniques for the evaluation of pleural effusions and performance of the thoracentesis procedure are discussed. A review of the most current literature follows to present the known diagnostic and safety benefits of ultrasound guidance for thoracentesis. Conclusions. Ultrasound improves the diagnostic accuracy for the detection of pleural effusions over standard chest radiographs. Ultrasound can also diagnose a complicated pleural effusion that may be at higher risk for an adverse outcome during a thoracentesis. Optimally, thoracentesis should be performed under direct ultrasound guidance to decrease the complication rate and improve patient safety.

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“…5 On the other hand, sonography has the capacity to clarify the nature of opaque lesions such as effusions, atelectasis, masses and consolidations. 8 Over the years, sonography has been restricted to detection of effusions and procedure guidance (thoracocentesis, biopsy or drainage), 2 providing a high success rate and low morbidity 5 . In recent years, studies have shown that sonography achieves better results than radiography in measuring the effusion volume.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, studies have shown that sonography achieves better results than radiography in measuring the effusion volume. [8][9][10][11] However, the confidence intervals for such measurements remain wide. For this reason, and because of the heterogeneity of the methods proposed in different studies, large-scale use of sonography has been impeded.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of sonography for pleural effusion: systematic review

et al. 2010

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CONTEXT AND OBJECTIVE: The initial method for evaluating the presence of pleural effusion was chest radiography. Isolated studies have shown that sonography has greater accuracy than radiography for this diagnosis; however, no systematic reviews on this matter are available in the literature. Thus, the aim of this study was to evaluate the accuracy of sonography in detecting pleural effusion, by means of a systematic review of the literature. DESIGN AND SETTING:This was a systematic review with meta-analysis on accuracy studies. This study was conducted in the Department of Diagnostic METHOD:The following databases were searched: Cochrane Library, Medline, Web of Science, Embase and Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). The references of relevant studies were also screened for additional citations of interest. Studies in which the accuracy of sonography for detecting pleural effusion was tested, with an acceptable reference standard (computed tomography or thoracic drainage), were included.RESULTS: Four studies were included. All of them showed that sonography had high sensitivity, specificity and accuracy for detecting pleural effusions. The mean sensitivity was 93% (95% confidence interval, CI: 89% to 96%), and specificity was 96% (95% CI: 95% to 98%). CONCLUSIONS:In different populations and clinical settings, sonography showed consistently high sensitivity, specificity and accuracy for detecting fluid in the pleural space.RESUMO CONTEXTO E OBJETIVOS: O método inicial para a avaliação da presença dos derrames pleurais foi a radiografia de tórax. Estudos isolados demonstraram que a ultrassonografia apresenta uma acurácia maior que a radiografia para este diagnóstico, entretanto, não se encontram disponíveis na literatura revisões sistemáticas sobre este tema. Assim, o objetivo deste estudo é avaliar a acurácia da ultrassonografia na detecção de derrame pleural, por meio de revisão sistemática da literatura. Caribe em Ciências da Saúde (Lilacs). As referências de estudos relevantes foram verificadas para adicionais citações de interesse. Foram incluídos estudos nos quais a acurácia da ultrassonografia para a detecção de derrame pleural tenha sido testada, com padrão referência aceitável (tomografia computadorizada ou drenagem torácica). TIPO DE ESTUDO E LOCAL: RESULTADOS:Foram incluídos quatro estudos. Todos apresentaram alta sensibilidade, especificidade e acurácia para a detecção de derrame pleural pela ultrassonografia. A sensibilidade média foi de 93% (intervalo de confiança, IC 95%: 89% a 96%), e a especificidade 96% (IC 95%: 95% a 98%). CONCLUSÕES:A ultrassonografia, em diferentes populações e cenários clínicos, apresentou consistentemente alta sensibilidade, especificidade e acurácia na detecção de líquido no espaço pleural.

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Ultrasound estimation of volume of pleural fluid in mechanically ventilated patients

Abstract: Easy quantification of pleural fluid may help to decide about performing thoracentesis in high-risk patients, although thoracentesis under ultrasound guidance appears to be a safe procedure.

Cited by 296 publications

References 17 publications

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Ultrasound for the Detection of Pleural Effusions and Guidance of the Thoracentesis Procedure

Diagnostic accuracy of sonography for pleural effusion: systematic review

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