用于创伤性气胸的即时诊断设备：未盲法的PneumoScan™灵敏度较低。

Point-of-Care Diagnostic Device for Traumatic Pneumothorax: Low Sensitivity of the Unblinded PneumoScan™.

作者信息

Rehfeldt M, Slagman A, Leidel B A, Möckel M, Lindner T

机构信息

Department of Anaesthesia & Intensive Care, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.

Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.

出版信息

Emerg Med Int. 2018 Apr 1;2018:7307154. doi: 10.1155/2018/7307154. eCollection 2018.

DOI:10.1155/2018/7307154

PMID:29805809

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5899859/

Abstract

BACKGROUND

Traumatic Pneumothorax (PTX) is a potentially life-threatening injury. It requires a fast and accurate diagnosis and treatment, but diagnostic tools are limited. A new point-of-care device (PneumoScan) based on micropower impulse radar (MIR) promises to diagnose a PTX within seconds. In this study, we compare standard diagnostics with PneumoScan during shock-trauma-room management.

PATIENTS AND METHODS

Patients with blunt or penetrating chest trauma were consecutively included in the study. All patients were examined including clinical examination with auscultation (CE) and supine chest radiography (CXR). In addition, PneumoScan-readings and thoracic ultrasound scan (US) were performed. Computed tomography (CT) served as gold standard.

RESULTS

CT scan revealed PTX in 11 patients. PneumoScan detected two PTX correctly but missed nine. 15 false-positive results were found by PneumoScan, leading to a sensitivity of 20% and specificity of 80%. Six PTX were detected through CE (sensitivity: 54,5%). CXR detected four (sensitivity: 27,3%) and thoracic US two PTX correctly (sensitivity: 25%).

CONCLUSION

The unblinded PneumoScan prototype did not confirm the promising results of previous studies. The examined standard diagnostics and thoracic US showed rather weak sensitivity as well. Until now, there is no appropriate point-of-care tool to rule out PTX.

摘要

背景

创伤性气胸（PTX）是一种可能危及生命的损伤。它需要快速准确的诊断和治疗，但诊断工具有限。一种基于微功率脉冲雷达（MIR）的新型即时检测设备（PneumoScan）有望在数秒内诊断出PTX。在本研究中，我们在休克创伤室管理期间将标准诊断方法与PneumoScan进行了比较。

患者与方法

连续纳入钝性或穿透性胸部创伤患者进行研究。所有患者均接受检查，包括听诊临床检查（CE）和仰卧位胸部X线摄影（CXR）。此外，还进行了PneumoScan读数和胸部超声扫描（US）。计算机断层扫描（CT）作为金标准。

结果

CT扫描显示11例患者存在PTX。PneumoScan正确检测出2例PTX，但漏诊了9例。PneumoScan发现15例假阳性结果，导致敏感性为20%，特异性为80%。通过CE检测出6例PTX（敏感性：54.5%）。CXR正确检测出4例（敏感性：27.3%），胸部US正确检测出2例PTX（敏感性：25%）。