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A Bedside Ultrasound Sign Ruling Out Pneumothorax in the Critically III : Lung Sliding FREE TO VIEW

Daniel A. Lichtenstein; Yves Menu
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Affiliations: From the Service de Réanimation Médicale, Hôpital Ambroise-Paré, Boulogne, France,  From the Service d'Imagerie Médicale, Hôpital Beaujon, Clichy, France

Affiliations: From the Service de Réanimation Médicale, Hôpital Ambroise-Paré, Boulogne, France,  From the Service d'Imagerie Médicale, Hôpital Beaujon, Clichy, France


1995 BY THE AMERICAN COLLEGE OF CHEST PHYSICIANS


Chest. 1995;108(5):1345-1348. doi:10.1378/chest.108.5.1345
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Abstract

Study objective: To describe and evaluate an ultrasound pattern useful in the diagnosis of pneumothorax.

Design: Ultrasound examination of "lung sliding," a respiratory movement visible when investigating the chest wall.

Setting: The medical ICU of a university-affiliated hospital.

Patients: The study group included 43 proved pneumothoraces, either by chest radiograph (n=40) or by CT (n=3). The control group included 68 hemithoraces in which the absence of pneumothorax was proved by CT.

Intervention: Analysis of anterior chest wall in supine patients.

Measurements and results: Feasibility was 98.1%. Disappearance of "lung sliding" was observed in 100% of 41 analyzable cases of pneumothorax vs 8.8% of the hemithorax without pneumothorax (6 of 68). In this series, sensitivity was 95.3%, specificity 91.1%, and negative predictive value 100% (p<0.001).

Conclusions: Ultrasound was a sensitive test for detection of pneumothorax, although false-positive cases were noted. The principal value of this test was that it could immediately exclude anterior pneumothorax.


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