Evaluation Of Pneumothorax Research Articles

Chest X-ray in Emergency Radiology: What Artificial Intelligence Applications Are Available?

Due to its widespread availability, low cost, feasibility at the patient's bedside and accessibility even in low-resource settings, chest X-ray is one of the most requested examinations in radiology departments. Whilst it provides essential information on thoracic pathology, it can be difficult to interpret and is prone to diagnostic errors, particularly in the emergency setting. The increasing availability of large chest X-ray datasets has allowed the development of reliable Artificial Intelligence (AI) tools to help radiologists in everyday clinical practice. AI integration into the diagnostic workflow would benefit patients, radiologists, and healthcare systems in terms of improved and standardized reporting accuracy, quicker diagnosis, more efficient management, and appropriateness of the therapy. This review article aims to provide an overview of the applications of AI for chest X-rays in the emergency setting, emphasizing the detection and evaluation of pneumothorax, pneumonia, heart failure, and pleural effusion.

Evaluation of pneumothorax in the neonatal intensive care unit

OBJECTIVE: Pneumothorax is one of the most common pulmonary air leak syndromes and appears more often in the newborn period than at any other time of life. We aimed to determine and compare the demographic characteristics, clinical courses and outcomes of newborns with primary and secondary pneumothorax in this study. MATERIAL AND METHODS: In this single-centre retrospective study, maternal and neonatal data were collected from medical records at Malatya Turgut Ozal University Hospital between January 2020 to July 2021. FINDINGS: Twenty nine newborns diagnosed with pneumothorax and of these, 16 were male (55.2%) and 19 (65.5%) were born by cesarean section and 6 (20.7%) were premature. The mean gestational age was 37.5±2.6 weeks and birth weight was 3063.4±53 grams. The median age at diagnosis was 5 h (1-96) and the mean hospital stay was 9.55±4.38 days. The mean drainage time was 4.1±2.13 days. 13 (44.8%) neonates were classified as primary, while 16 patients (55.2%) had an underlying pulmonary disease or predisposing factor. Our study demonstrated a statistically significant difference between groups in terms of Apgar score 5th min and SNAP-II scores (p < 0.05). The occurance of pneumothorax was significantly earlier in the primary group (p < 0.05). Our study revealed significantly longer total oxygen, CPAP and mechanical ventilation durations in the secondary pneumothorax group (p < 0.05). RESULTS: Neonatal pneumothorax is still associated with significant morbidity and mortality and primary pneumothorax had more favorable outcomes than secondary pneumothorax. KEYWORDS: Newborn, Pneumothorax, Respiratory distress

Ultrasound applied to nursing in the Emergency Medical Service (EMS): a scoping review

Abstract Background: In recent years, ultrasound has represented a new field of application for nursing. Point of Care UltraSound (POCUS) has been defined as an essential skill in the pre-hospital setting. The primary objective of this scoping review is to describe what are the main ultrasound techniques applied by nurses in the pre-hospital emergency setting. The secondary objective is to identify the different training courses implemented in the various studies selected to learn the necessary ultrasound skills. Methods: We conducted a scoping review. The following databases were consulted: PubMed, Cochrane Library, CINAHL and Google Scholar. For the extraction of useful articles, after identifying the inclusion and exclusion criteria, the PRISMA methodology was used, two authors independently analyzed the identified records, in the event of a conflict a third author intervened. Results: The identified records were initially 815. After the duplicates removal, and screening made by the researcher for inclusion criteria, 6 articles were retrieved for qualitative analysis. The most discussed topic is the recognition of pneumothorax: two studies analyzed a specific educational program on ultrasound for flight nurses, three articles evaluated the us of US to verify the correct insertion of devices, and two explored the skills of nurses in performing ultrasound scans. The first study stated that nurses had 86.4% accuracy, 66.6% sensitivity and 100% specificity in ultrasound using; in the second one, nurses had a sensitivity and specificity of 100% in non-traumatized patients and a sensitivity of 60% and a specificity of 93% in trauma patients. Conclusions: Despite the methodological differences of the selected records, the main ultrasound techniques implemented by nurses in the Emergency Medical Service (EMS) are Focused Assessment with Sonography for Trauma (FAST), Extendend Focused Assessment with Sonography for Trauma (E-FAST), evaluation of pneumothorax and visualization of correct insertion of devices (Endotracheal Tube, Nasogastric Tube). At the level of training in the ultrasound field, on the other hand, a certain heterogeneity is highlighted in the structuring of training courses, both in terms of hours of theory and of controlled practice.

A Comparative Evaluation of Pneumothorax in Ventilated Patients of COVID-19

A Comparative Evaluation of Pneumothorax in Ventilated Patients of COVID-19

Point-of-care ultrasound use in pediatric intensive care units in Turkey.

Point-of-care ultrasound is commonly used in pediatric intensive care units in recent years. The aim of this study was to find an answer to the question `where are we now in Turkish pediatric intensive care units for point-of-care ultrasound use?`. This was a multicenter, descriptive study in which we developed an online survey. We asked 45 questions about point-of-care ultrasound using fields and training status of clinicians in pediatric intensive care units. A total of 29 units responded to the questions completely. Of all included units 41.4% were in public hospitals, 6.9% in city hospitals (public-private partnership) and 51.7% in university hospitals. The most common use of point-of-care ultrasound was central venous catheter insertion. Lung ultrasound use rates for detection of pleural effusion, evaluation of pneumothorax, and diagnosis of pneumonia were 93.1%, 86.2%, and 34.5%, respectively. Critical care echocardiography use rate was 79.3%. In 89.7% of the units, intensive care specialists had been specifically trained for the use of point-of-care ultrasound. Our study showed that point-of-care ultrasound was not only used for central venous catheterization but also for widespread fields in pediatric intensive care units. With an experienced team, it is possible to perform rapid, noninvasive and repeatable ultrasonographic assessment of patients. In our view point-of-care ultrasound is the new stethoscope of critical care physicians.

AIUM Practice Parameter for the Performance of Point-of-Care Ultrasound Examinations.

AIUM Practice Parameter for the Performance of Point-of-Care Ultrasound Examinations.

A Comparative Study between Bedside Chest Ultrasound and Traditional Chest Radiography in Critically Ill Patients

Background: Bedside chest ultrasound emerge a sensitive tool with much higher sensitivity than plain chest x-ray. It avoids the cost, risk of transportation to perform the CT chest and that of radiation exposure. Aim of the Study: was to evaluate the sensitivity and the specificity of bedside ultrasound in the detection and the evaluation of chest conditions of critically ill patients in comparison of CT chest as the gold standard tool. Patients and Methods: This prospective study was conducted on a registry of 80 patients with different chest pathology admitted to the Medical-Surgical Intensive Care Unit of Bab Al Shaeria Hospital between March and November 2018. Results: bedside chest ultrasound sensitivity in detection and evaluation of pneumothorax, pleural effusion, and consolidation and Interstitial lung disease in comparison to CT chest showed sensitivity around 93 % with little cost, without risk of radiation exposure and transportation of critically ill patients. Conclusion: Bedside chest ultrasound is a highly sensitive and specific tool in the detection and evaluation of many chest conditions that eliminates the risk of transportation of unstable patients and that of radiation exposure and is easily accessible in resource limited areas.

Evaluation of pneumothorax in the first month of life.

Evaluation of pneumothorax in the first month of life.

A Comparative Study between Bedside Chest Ultrasound and Traditional Chest Radiography in Critically Ill Patients

Background: Bedside chest ultrasound emerge a sensitive tool with much higher sensitivity than plain chest x-ray. It avoids the cost, risk of transportation to perform the CT chest and that of radiation exposure. Aim of the Study: was to evaluate the sensitivity and the specificity of bedside ultrasound in the detection and the evaluation of chest conditions of critically ill patients in comparison of CT chest as the gold standard tool. Patients and Methods: This prospective study was conducted on a registry of 80 patients with different chest pathology admitted to the Medical-Surgical Intensive Care Unit of Bab Al Shaeria Hospital between March and November 2018. Results: bedside chest ultrasound sensitivity in detection and evaluation of pneumothorax, pleural effusion, and consolidation and Interstitial lung disease in comparison to CT chest showed sensitivity around 93 % with little cost, without risk of radiation exposure and transportation of critically ill patients. Conclusion: Bedside chest ultrasound is a highly sensitive and specific tool in the detection and evaluation of many chest conditions that eliminates the risk of transportation of unstable patients and that of radiation exposure and is easily accessible in resource limited areas.

Case Study: Traumatic Pneumothorax after Parachute Landing

Introduction: Pneumothorax during military airborne operations is an uncommon injury among paratroopers. More common injuries are fractures or sprains to the lower extremities, as this is where most of the impact is absorbed during parachute landings. Classically, a pneumothorax will present with sudden onset severe chest pain and dyspnea warranting immediate medical evaluation. Among military service members, pneumothorax is more likely to occur because of traumatic injuries such as from motor vehicle accidents. Case presentation: This case highlights an otherwise healthy male paratrooper, who presented 24 hours following routine airborne training. Conclusion: Symptoms of even mild dyspnea or chest pain in military paratroopers following airborne operations should prompt immediate evaluation for pneumothorax.

Demystifying the persistent pneumothorax: role of imaging.

Evaluation for pneumothorax is an important indication for obtaining chest radiographs in patients who have had trauma, recent cardiothoracic surgery or are on ventilator support. By definition, a persistent pneumothorax constitutes ongoing bubbling of air from an in situ chest drain, 48 h after its insertion. Persistent pneumothorax remains a diagnostic dilemma and identification of potentially treatable aetiologies is important. These may be chest tube related (kinks or malposition), lung parenchymal disease, bronchopleural fistula, or rarely, oesophageal-pleural fistula. Although radiographs remain the mainstay for diagnosis and follow up of pneumothorax, computed tomography (CT) is increasingly being used for problem solving. Aetiology of persistent air leak determines the optimal treatment. For some, a simple repositioning of the chest tube/drain may suffice; others may require surgery. In this pictorial review, we will briefly describe the physiology of pneumothorax, discuss imaging features of identifiable causes for persistent pneumothorax and provide a brief overview of treatment options. Specific aetiology of a persistent air leak may often not be immediately discernible, and will need to be carefully sought. Accurate interpretation of imaging studies can expedite diagnosis and facilitate prompt treatment.Key points• Persistent pneumothorax is defined as a leak persisting for more than 2 days.• Radiographs can identify chest-tube-related causes of pneumothorax.• CT is the most useful test to identify other causes.• Penetrating thoracic injury can cause fistulous communication resulting in a persistent pneumothorax.• Discontinuity of visceral pleura identified by CT may indicate a bronchopleural fistula.

The Ultrasound-Only Central Venous Catheter Placement and Confirmation Procedure.

The placement of a central venous catheter remains an important intervention in the care of critically ill patients in the emergency department. We propose an ultrasound-first protocol for 3 aspects of central venous catheter placement above the diaphragm: dynamic procedural guidance, evaluation for pneumothorax, and confirmation of the catheter tip location.

The Interpretation and Utility of Thoracic Ultrasound in the Evaluation of Pneumothorax in a Critically Ill Patient: Case Report and Literature Review

The Interpretation and Utility of Thoracic Ultrasound in the Evaluation of Pneumothorax in a Critically Ill Patient: Case Report and Literature Review

Ultrasound diagnosis of pneumothorax

The purpose of this study was to show the effectiveness of ultrasound (US) in the evaluation of pneumothorax by comparison with X-rays and computed tomography (CT). A series of 184 patients (130 men and 54 women), aged 26 to 82 years, underwent chest US after percutaneous needle biopsy. US findings were compared with CT postbiopsy selective slices and to X-rays. Pneumothorax was identified in 46 patients (25%) by CT, in 44 by US, with no false positives, and in 19 by X-rays. US sensitivity was 95.65%, specificity 100% and diagnostic effectiveness 98.91%. Chest US was found to be a valuable diagnostic tool in pneumothorax diagnosis, with diagnostic effectiveness well beyond X-rays and similar to CT.