Abstract
Introduction and purpose: Pneumothorax is a condition in which air is present in the pleural cavity and often has a traumatic etiology. It can be a life-threatening condition, making quick and effective diagnosis essential. Chest ultrasound can be a useful study for this purpose.A brief description of the state of knowledge: The sonographic signs of pneumothorax are absence of lung sliding, absence of B-lines, absence of lung pulse and presence of lung point. When a pneumothorax is suspected, the supine position is the most appropriate position for the patient. The sonographic technique consists of exploration of the least gravitationally dependent areas progressing more laterally. The bedside sonographic diagnosis of pneumothorax can be performed with most ultrasound machines without the need of any sophisticated functions. The average time to perform this examination varies from two to three minutes. In the most recent meta-analysis chest ultrasound sensitivity and specificity were 0.91 (95% CI: 0.85 to 0.94) and 0.99 (95% CI: 0.97 to 1.00), respectively. There was a significant difference in the sensitivity of CUS compared to CXR with an absolute difference in sensitivity of 0.44 (95% CI: 0.27 to 0.61; P<0.001).Conclusions: Chest ultrasound is a safe, effective and sensitive method of diagnosing pneumothorax. It may be considered as the first study of trauma patients with suspected pneumothorax.
Highlights
Introduction and purposePneumothorax is a condition in which air is present in the pleural cavity and often has a traumatic etiology
Chest ultrasound is a safe, effective and sensitive method of diagnosing pneumothorax. It may be considered as the first study of trauma patients with suspected pneumothorax
In the most recent meta-analysis by Chan et al, which aimed to compare the effectiveness of the diagnosis of chest ultrasonography by frontline non-radiologist physicians versus supine chest x-ray for diagnosis of pneumothorax in trauma patients in the emergency department, ultrasonography had a sensitivity of 0.91 and a specificity of 0.99
Summary
Pneumothorax is a condition in which air is present in the pleural cavity. This is the second most common consequence of a blunt chest injury[1]. The gold standard in the detection of pneumothorax is computed tomography, which is able to visualize the occult pneumothorax, i.e. one that is not visible on a chest X-ray[6,7] It has limitations such as the dose of radiation taken by the patient, the cost, and the fact that some patients are not transportable for examination. It is performed in a supine position and is accessible at the bedside, it does not require transport and can be safely performed even during resuscitation It is characterized by high sensitivity and specificity, which allows for an effective rule in and rule out the diagnosis of pneumothorax[4,8,9,10]
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