Bhoil Rohit, Kumar Ranesh, Kaur Jaswinder, Attri Pardeep K, Thakur Rohini
Department of Radiodiagnosis, SLBS Medical College, Mandi, Himachal Pradesh, India.
Department of Surgery, SLBS Medical College, Mandi, Himachal Pradesh, India.
Indian J Crit Care Med. 2021 Feb;25(2):176-180. doi: 10.5005/jp-journals-10071-23729.
BACKGROUND/OBJECTIVE: Traumatic pneumothorax is an ominous condition necessitating urgent appropriate action. It is typically detected on chest X-rays; however, these may not be able to detect the presence of a subtle pneumothorax, especially in supine position. Lung ultrasound is emerging as a promising modality for detecting pneumothorax in trauma patients. The aim of our study was to compare ultrasound with supine chest radiography for the detection of pneumothorax in trauma patients.
This was a prospective, single-blinded study carried out on 212 adult thoracoabdominal trauma patients who underwent ultrasound FAST and supine (AP) chest radiography. During the FAST sonography, ultrasound thorax was done to rule out pneumothorax. Only those cases were considered (118) in which the presence or absence of pneumothorax could be confirmed on CT done subsequently or where pneumothorax was confirmed by air escape on chest tube placement, wherever indicated, and the results were compared with sonographic and chest X-ray findings.
OBSERVATION/RESULTS: There were 48 true positives on CT/chest tube insertion. Among these, ultrasound was able to correctly detect pneumothorax in 43 patients, while supine chest X-rays correctly identified 33 cases. Sensitivity of ultrasound was 89.6 vs. 68.8% of supine chest radiography. Lung ultrasound also had a higher negative predictive value as compared to supine chest X-rays.
Lung ultrasound is more sensitive in detecting traumatic pneumothorax than supine chest X-rays, in addition to having numerous other inherent advantages over chest radiography. It should be incorporated in the emergency assessment of thoracic trauma patients to rule out pneumothorax.
Lung sonography is more sensitive in detecting traumatic pneumothorax than supine chest X-rays. No added equipment is required, and the procedure can be carried out at the time of doing ultrasound FAST, thus saving precious time in trauma patients.
Bhoil R, Kumar R, Kaur J, Attri PK, Thakur R. Diagnosis of Traumatic Pneumothorax: A Comparison between Lung Ultrasound and Supine Chest Radiographs. Indian J Crit Care Med 2021;25(2):176-180.
背景/目的：创伤性气胸是一种严重情况，需要紧急采取适当措施。通常通过胸部X线检查来发现；然而，这些检查可能无法检测到细微气胸的存在，尤其是在仰卧位时。肺部超声正成为检测创伤患者气胸的一种有前景的方法。我们研究的目的是比较超声与仰卧位胸部X线摄影在检测创伤患者气胸方面的效果。
这是一项前瞻性、单盲研究，对212例接受超声快速扫查（FAST）和仰卧位（前后位）胸部X线摄影的成年胸腹创伤患者进行。在FAST超声检查期间，进行胸部超声检查以排除气胸。仅考虑那些随后通过CT能够确认气胸是否存在的病例（118例），或者在必要时通过胸腔置管时气体逸出确认气胸的病例，并将结果与超声和胸部X线检查结果进行比较。
观察/结果：CT/胸腔置管检查中有48例假阳性。其中，超声能够正确检测出43例患者的气胸，而仰卧位胸部X线摄影正确识别出33例。超声的敏感性为89.6%，而仰卧位胸部X线摄影为68.8%。与仰卧位胸部X线摄影相比，肺部超声的阴性预测值也更高。
肺部超声在检测创伤性气胸方面比仰卧位胸部X线摄影更敏感，此外与胸部X线摄影相比还有许多其他固有优势。应将其纳入胸部创伤患者的紧急评估中以排除气胸。
肺部超声在检测创伤性气胸方面比仰卧位胸部X线摄影更敏感。无需额外设备，并且该操作可在进行超声FAST检查时同时进行，从而为创伤患者节省宝贵时间。
Bhoil R, Kumar R, Kaur J, Attri PK, Thakur R. 创伤性气胸的诊断：肺部超声与仰卧位胸部X线片的比较。《印度危重症医学杂志》2021；25(2):176 - 180。
