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dc.contributor.authorOveland, Nils Petteren_US
dc.contributor.authorSøreide, Eldaren_US
dc.contributor.authorLossius, Hans Mortenen_US
dc.contributor.authorJohannessen, Frodeen_US
dc.contributor.authorWemmelund, Kristian Borupen_US
dc.contributor.authorAagaard, Rasmusen_US
dc.contributor.authorSloth, Eriken_US
dc.date.accessioned2013-12-04T10:02:33Z
dc.date.available2013-12-04T10:02:33Z
dc.date.issued2013-03-01eng
dc.PublishedScandinavian Journal of Trauma, Resuscitation and Emergency Medicine 21(1):11eng
dc.identifier.issn1757-7241
dc.identifier.urihttps://hdl.handle.net/1956/7572
dc.description.abstractBackground: Small pneumothoraxes (PTXs) may not impart an immediate threat to trauma patients after chest injuries. However, the amount of pleural air may increase and become a concern for patients who require positive pressure ventilation or air ambulance transport. Lung ultrasonography (US) is a reliable tool in finding intrapleural air, but the performance characteristics regarding the detection of small PTXs need to be defined. The study aimed to define the volume threshold of intrapleural air when PTXs are accurately diagnosed with US and compare this volume with that for chest x-ray (CXR). Methods: Air was insufflated into a unilateral pleural catheter in seven incremental steps (10, 25, 50, 100, 200, 350 and 500 mL) in 20 intubated porcine models, followed by a diagnostic evaluation with US and a supine anteroposterior CXR. The sonographers continued the US scanning until the PTXs could be ruled in, based on the pathognomonic US “lung point” sign. The corresponding threshold volume was noted. A senior radiologist interpreted the CXR images. Results: The mean threshold volume to confirm the diagnosis of PTX using US was 18 mL (standard deviation of 13 mL). Sixty-five percent of the PTXs were already diagnosed at 10 mL of intrapleural air; 25%, at 25 mL; and the last 10%, at 50 mL. At an air volume of 50 mL, the radiologist only identified four out of 20 PTXs in the CXR pictures; i.e., a sensitivity of 20% (95% CI: 7%, 44%). The sensitivity of CXR increased as a function of volume but leveled off at 67%, leaving one-third (1/3) of the PTXs unidentified after 500 mL of insufflated air. Conclusion: Lung US is very accurate in diagnosing even small amounts of intrapleural air and should be performed by clinicians treating chest trauma patients when PTX is among the differential diagnoses.en_US
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/7574" target="blank">Ultrasound Detection of Pneumothorax. Development of a porcine pneumothorax model to assess and teach lung ultrasound diagnostics</a>eng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/eng
dc.subjectPneumothoraxeng
dc.subjectUltrasonographyeng
dc.subjectChest x-rayeng
dc.subjectComputed tomographyeng
dc.titleThe intrapleural volume threshold for ultrasound detection of pneumothoraces: An experimental study on porcine modelsen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2013-08-23T08:53:28Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2013 Oveland et al; licensee BioMed Central Ltd.
dc.rights.holderNils Petter Oveland et al.; licensee BioMed Central Ltd.
dc.source.articlenumber11
dc.identifier.doihttps://doi.org/10.1186/1757-7241-21-11
dc.identifier.cristin1037047
dc.source.journalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
dc.source.4021


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