Abstract
Background: Historically ultrasound technology has not been applied to respiratory medicine because of its inability to produce anatomic images of the lung. Since 1995 Lichtenstein et al, (Chest 1995, 108(1) 117-125) has proved the importance of the evaluation of the pleural line and its clinical implications.
Method: We performed a bedside transthoracic ultrasound evaluation in 36 post surgery hemi-thoraces in which non pulmonary surgery was performed (i.e. bilateral sympathectomies and thoracoscopic pleural biopsies). We registered the presence or absence of lung sliding. The result was paired with digital air leak values and compared with chest x-rays.
Results: Lung sliding was present in all 36 cases, digital air leak values of 0 ml/min where observed in all cases and a conventional chest x-ray showed full lung expansion in all cases. A 100% agreement (Cohen Kappa 1.0) was found between all three tests.
Discussion: The presence of lung sliding in a transthoracic ultrasound evaluation is a sign that both parietal and visceral pleura are in contact as there is no air between them and thus they slide with respiratory movements, this is proved by the presence of an air leak value of 0 ml/min in our series making the possibility of pneumothorax very unlikely. The perfect agreement between lung ultrasound and an air leak value of 0 ml/min demonstrates that lung ultrasound can exclude pneumothorax.
Conclusion: The observation of lung sliding in a transthoracic lung ultrasound evaluation can safely diagnose full lung expansion in the post non pulmonary thoracic surgery patient, without the need for other radiographic explorations.
- © 2013 ERS
