PURPOSE: In many institutions, a chest radiograph (CXR)is routinely ordered following bronchoscopy with transbronchial biopsy (TBBX). Bedside thoracic ultrasound has been shown to be effecting in the detecting and excluding the presence of pneumothoracies. We investigated whether bedside thoracic ultrasound can equally determine the presence or absence of a post TBBX pneumothorax when compared to a CXR.
METHODS: Patients that had a bronchoscopy with TBBX underwent a pre and post procedure bedside thoracic ultrasound. This was followed by a routine CXR to assess for the presence or absence of a pneumothorax. Ultrasound findings assessed were: 1. The presence of a "sliding sign" of the pleural surfaces 2. "beach sign" on M mode 3. presence of comet tails during 4 point chest wall imaging. The data from the findings of the ultrasound were collected and compared to the results of the CXR interpretations performed by independent radiologists.
RESULTS: Twenty nine patients underwent a pre and post TBBX ultrasound followed by a post procedure CXR. No patients had a pneumothorax detected by ultrasound prior to or immediately following the procedure. In each case, the following CXR confirmed the absence of a pneumothorax. There were no cases of a pneumothorax in our patient population.
CONCLUSION: The results of a bedside ultrasound, following a TBBX, are equal to CXR in the absence of a pneumothorax. This suggests that when an ultrasound shows no evidence of pneumothorax, a CXR may not be necessary.
CLINICAL IMPLICATIONS: Bedside ultrasound performed before and following a TBBX has the potential to reduce the amount of radiation exposure and the time and costs associated with the procedure.
DISCLOSURE: Binu George, No Financial Disclosure Information; No Product/Research Disclosure Information