The use of lung ultrasound in the diagnosis of pneumothorax in trauma patients

Abstract

Introduction and purpose: Pneumothorax is a condition in which air is present in the pleural cavity and often has a traumatic etiology. It can be a life-threatening condition, making quick and effective diagnosis essential. Chest ultrasound can be a useful study for this purpose.

A brief description of the state of knowledge: The sonographic signs of pneumothorax are absence of lung sliding, absence of B-lines, absence of lung pulse and presence of lung point. When a pneumothorax is suspected, the supine position is the most appropriate position for the patient. The sonographic technique consists of exploration of the least gravitationally dependent areas progressing more laterally. The bedside sonographic diagnosis of pneumothorax can be performed with most ultrasound machines without the need of any sophisticated functions. The average time to perform this examination varies from two to three minutes. In the most recent meta-analysis chest ultrasound sensitivity and specificity were 0.91 (95% CI: 0.85 to 0.94) and 0.99 (95% CI: 0.97 to 1.00), respectively. There was a significant difference in the sensitivity of CUS compared to CXR with an absolute difference in sensitivity of 0.44 (95% CI: 0.27 to 0.61; P<0.001).

Conclusions: Chest ultrasound is a safe, effective and sensitive method of diagnosing pneumothorax. It may be considered as the first study of trauma patients with suspected pneumothorax.