The DOI matches its Crossref record; 15 of the 15 references it cites were found in a registry or an index.
Ultrasound diagnosis of occult pneumothorax*
Abstract
OBJECTIVES: Pneumothorax can be missed by bedside radiography, and computed tomography is the current alternative. We asked whether lung ultrasound could be of any help in this situation. DESIGN: Retrospective study. SETTING: The medical intensive care unit of a university-affiliated teaching hospital. PATIENTS: All patients admitted to the intensive care unit are routinely scanned with whole-body ultrasound (including screening for pneumothorax) and chest radiography. The study population included 200 consecutive undifferentiated intensive care unit patients who received a chest computed tomography scan in addition to ultrasound and chest radiograph. Forty-seven consecutive cases of radioccult pneumothorax were compared with 310 consecutive hemithoraces free from pneumothorax in the intensive care unit. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Three signs were investigated at the anterolateral chest wall in supine patients: lung sliding, the A line sign, and the lung point. A total of 357 hemithoraces were analyzed in this study, 47 with occult pneumothorax and 310 controls. Four of the 47 cases of pneumothorax were excluded from the final analysis (parietal emphysema) as well as eight of the 310 controls (large dressings), leaving a final study population of 345 hemithoraces in 197 patients. Feasibility was 98%. Ultrasound scans in all 43 examinable patients with pneumothorax showed absent lung sliding, 41 of 43 patients had the A line sign, and 34 exhibited a lung point. Among 302 analyzable controls, 65 had absent lung sliding, 16 of them showed an A line sign, and none showed a lung point. For the diagnosis of occult pneumothorax, the abolition of lung sliding alone had a sensitivity of 100% and a specificity of 78%. Absent lung sliding plus the A line sign had a sensitivity of 95% and a specificity of 94%. The lung point had a sensitivity of 79% and a specificity of 100%. CONCLUSIONS: For the diagnosis of occult pneumothorax, ultrasound can decrease the need for computed tomography.
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Citations
Cites
Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT
Brenner, D. J., Elliston, C. D., Hall, E. J., & Berdon, W. E. (2001) · American Journal of Roentgenology · doi:10.2214/ajr.176.2.1760289 · Cited by 3,222 · cited 1×
“Computed tomography (CT), the current gold standard, solves this problem but introduces major drawbacks (transfer of critically ill patients, delay, irradiation, and cost, among others), whereas the excessive search for pneumothorax has similar drawbacks (12).”
BackgroundLichtenstein, D., Goldstein, I., Mourgeon, E., Cluzel, P., Grenier, P., & Rouby, J.-J. (2004) · Anesthesiology · doi:10.1097/00000542-200401000-00006 · Cited by 1,077
Self-citationThe Comet-tail Artifact: An Ultrasound Sign of Alveolar-Interstitial Syndrome
LICHTENSTEIN, D., MÉZIÈRE, G., BIDERMAN, P., GEPNER, A., & BARRÉ, O. (1997) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.156.5.96-07096 · Cited by 1,075
Self-citationYearbook of Intensive Care and Emergency Medicine 2002
(2002) · Springer eBooks · doi:10.1007/978-3-642-56011-8 · Cited by 876
A Bedside Ultrasound Sign Ruling Out Pneumothorax in the Critically III
Lichtenstein, D. A., & Menu, Y. (1995) · Chest · doi:10.1378/chest.108.5.1345 · Cited by 787
Self-citationSahn, S. A., & Heffner, J. E. (2000) · New England Journal of Medicine · doi:10.1056/nejm200003233421207 · Cited by 674
Ultrasound diagnosis of alveolar consolidation in the critically ill
Lichtenstein, D. A., Lascols, N., Mezière, G., & Gepner, A. (2004) · Intensive Care Medicine · doi:10.1007/s00134-003-2075-6 · Cited by 512
Self-citationThe comet-tail artifact: an ultrasound sign ruling out pneumothorax
Lichtenstein, D., Mezière, G., Biderman, P., & Gepner, A. (1999) · Intensive Care Medicine · doi:10.1007/s001340050862 · Cited by 466
Self-citationLichtenstein, D., & Mezière, G. (1998) · Intensive Care Medicine · doi:10.1007/s001340050771 · Cited by 412
Self-citationDistribution of pneumothorax in the supine and semirecumbent critically ill adult
Tocino, I., Miller, M., & Fairfax, W. (1985) · American Journal of Roentgenology · doi:10.2214/ajr.144.5.901 · Cited by 296
Cited by
Copetti, R., Soldati, G., & Copetti, P. (2008) · Cardiovascular Ultrasound · doi:10.1186/1476-7120-6-16 · Cited by 555
Breitkreutz, R., Walcher, F., & Seeger, F. H. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000260626.23848.fc · Cited by 417
Gentry Wilkerson, R., & Stone, M. B. (2010) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2009.00628.x · Cited by 301
Metadata
- Authors
- Lichtenstein, D. A., Mezière, G., Lascols, N., Biderman, P., Courret, J.-P., Gepner, A., Goldstein, I., & Tenoudji-Cohen, M.
- Venue
- Critical Care Medicine
- Published
- 2005-06
- Volume
- 33
- Issue
- 6
- Pages
- 1231-1238
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2161590196
- Cited by
- 632
- References
- 15
- FWCI
- 12.53
- Type
- journal article
- Language
- en
- Open access
- closed
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- Lichtenstein, D. A., Mezière, G., Lascols, N., Biderman, P., Courret, J.-P., Gepner, A., Goldstein, I., & Tenoudji-Cohen, M. (2005). Ultrasound diagnosis of occult pneumothorax*. Critical Care Medicine. https://doi.org/10.1097/01.ccm.0000164542.86954.b4
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