Effectiveness of Bedside Lung Ultrasound for Clinical Follow-Up of Primary Spontaneous Pneumothorax Patients Treated With Tube Thoracostomy. Issue 4 (December 2018)

• Record Type: Journal Article
• Authors: Karagöz, Arif; Ünlüer, Erden Erol; Akçay, Onur; Kadioğlu, Emine
• Is Part Of: Ultrasound quarterly. Volume 34:Issue 4(2018)
• Publication Date: 2018-12
• Subjects: bedside ultrasound -- pneumothorax -- tube thoracostomy; Diagnostic ultrasonic imaging -- Periodicals; 616.07543
• DOI: 10.1097/RUQ.0000000000000363
• Languages: English
• ISSNs: 0894-8771

Abstract

Abstract : Abstract: Primary spontaneous pneumothorax (PSP) is a common cause of presentation to emergency departments and subsequent hospitalization. Patients with large PSP are treated with tube thoracostomy (TT) and followed up with x-rays. In this study, we investigated the efficiency of bedside ultrasound and compared it with x-ray imaging for the clinical follow-up of PSP patients treated with TT. This is a prospective observational study. After ethical committee approval and written informed consent were obtained, patients who were treated with TT because of PSP were screened. In the follow-up of these patients, a bedside lung ultrasound (BLUS) was performed before every chest x-ray by an emergency physician experienced in performing BLUSs. The performance of BLUSs in detecting free air in the pleural cavity was compared statistically with that of x-rays. Sixty-two patients were enrolled in the study. In total, 166 BLUSs and x-rays were compared. The sensitivity of BLUS was 95.65% (85.20–99.50), specificity was 100% (79.40–100.00), positive predictive value was 100% (92–100), negative predictive value was 88.90% (65.30–98.60), and the area under the curve was 0.99 (0.974–1.000; P = 0.001) for detecting air in the pleural cavity. These results showed that there was no statistically significant difference between BLUS and x-ray methods for detecting air in the pleural cavity. Our study revealed that BLUS can be safely used for the follow-up of PSP patients treated with TT to determine if air is present in the pleural cavity. Further studies are needed. Abstract : Supplemental digital content is available in the text.