Daniel J Jakobson1,2, Ornit Cohen3, Evgenia Cherniavsky2,4, Moris Batumsky2,5, Lior Fuchs2,6, Alon Yellin2,7. 1. Intensive Care Department, Barzilai University Medical Center, Ashkelon, Israel. 2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel. 3. Faculty of Public Health Ben-Gurion University, Beer-Sheba, Israel. 4. Radiology Department, Barzilai University Medical Center, Ashkelon, Israel. 5. General Surgery Department, Barzilai University Medical Center, Ashkelon, Israel. 6. Intensive Care Department, Soroka University Medical Center, Beer Sheba, Israel. 7. Thoracic Surgery Department, Barzilai University Medical Center, Ashkelon, Israel.
Abstract
OBJECTIVES: Lung ultrasound accurately identifies pulmonary and pleural pathologies. Presently it has not been accepted as a routine examination in the postoperative follow-up of thoracic surgical patients. The present study aimed to compare thoracic ultrasonography with chest X-ray for detecting and clinical relevance of pneumothorax, pleural effusion, and lung consolidation and determine whether ultrasonography could replace chest X-ray as the standard examination after surgery. METHODS: In this blinded, prospective, single-center study, lung ultrasound images were obtained within 2 hours of post-operative routine chest X-ray. A severity score was given to each examination in each technique. Lung ultrasound and chest X-ray results were compared by three methods: absolute comparison of normal to abnormal, the degree of pathology, and the clinical findings' relevance. RESULTS: Eighty patients were enrolled from 2013 to 2017, and 215 ultrasonography images were obtained. For pneumothorax, the precise overlap was found in 129/180 (72%) images. In 24% of examinations, X-ray missed ultrasonography findings. There was an agreement between studies in 80/212 (38%) images for pleural effusion. 60% of pleural effusions were missed by chest X-ray and detected by ultrasonography, and only 2.4% were missed by ultrasound, all very small. Clinically relevant fluid accumulation found a precise match in 80%, and 20% were found only by lung ultrasound. For lung consolidation, a 100% overlap was found with both methods. CONCLUSIONS: Our results suggest that lung ultrasound may replace chest X-ray as the standard examination in the postoperative care of patients undergoing thoracic surgical procedures.
OBJECTIVES: Lung ultrasound accurately identifies pulmonary and pleural pathologies. Presently it has not been accepted as a routine examination in the postoperative follow-up of thoracic surgical patients. The present study aimed to compare thoracic ultrasonography with chest X-ray for detecting and clinical relevance of pneumothorax, pleural effusion, and lung consolidation and determine whether ultrasonography could replace chest X-ray as the standard examination after surgery. METHODS: In this blinded, prospective, single-center study, lung ultrasound images were obtained within 2 hours of post-operative routine chest X-ray. A severity score was given to each examination in each technique. Lung ultrasound and chest X-ray results were compared by three methods: absolute comparison of normal to abnormal, the degree of pathology, and the clinical findings' relevance. RESULTS: Eighty patients were enrolled from 2013 to 2017, and 215 ultrasonography images were obtained. For pneumothorax, the precise overlap was found in 129/180 (72%) images. In 24% of examinations, X-ray missed ultrasonography findings. There was an agreement between studies in 80/212 (38%) images for pleural effusion. 60% of pleural effusions were missed by chest X-ray and detected by ultrasonography, and only 2.4% were missed by ultrasound, all very small. Clinically relevant fluid accumulation found a precise match in 80%, and 20% were found only by lung ultrasound. For lung consolidation, a 100% overlap was found with both methods. CONCLUSIONS: Our results suggest that lung ultrasound may replace chest X-ray as the standard examination in the postoperative care of patients undergoing thoracic surgical procedures.
Authors: Bélaïd Bouhemad; Zhi-Hai Liu; Charlotte Arbelot; Mao Zhang; Fabio Ferarri; Morgan Le-Guen; Martin Girard; Qin Lu; Jean-Jacques Rouby Journal: Crit Care Med Date: 2010-01 Impact factor: 7.598
Authors: H R Touw; K L Parlevliet; M Beerepoot; P Schober; A Vonk; J W Twisk; P W Elbers; C Boer; P R Tuinman Journal: Anaesthesia Date: 2018-03-12 Impact factor: 6.955