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Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray
Background The role of chest drain (CD) location by bedside imaging methods in the diagnosis of pneumothorax has not been explored in a prospective study yet. Methods Covid-19 ARDS patients with pneumothorax were prospectively monitored with chest ultrasound (CUS) and antero-posterior X-ray (CR) per...
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| Published in: | The ultrasound journal 2022-11, Vol.14 (1), p.45-45, Article 45 |
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| container_title | The ultrasound journal |
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| creator | Maly, Michal Mokotedi, Masego Candy Svobodova, Eva Flaksa, Marek Otahal, Michal Stach, Zdenek Rulisek, Jan Brozek, Tomas Porizka, Michal Balik, Martin |
| description | Background
The role of chest drain (CD) location by bedside imaging methods in the diagnosis of pneumothorax has not been explored in a prospective study yet.
Methods
Covid-19 ARDS patients with pneumothorax were prospectively monitored with chest ultrasound (CUS) and antero-posterior X-ray (CR) performed after drainage in the safe triangle. CD foreshortening was estimated as a decrease of chest drain index (CDI = length of CD in chest taken from CR/depth of insertion on CD scale + 5 cm). The angle of inclination of the CD was measured between the horizontal line and the CD at the point where it enters pleural space on CR.
Results
Of the total 106 pneumothorax cases 80 patients had full lung expansion on CUS, the CD was located by CUS in 69 (86%), the CDI was 0.99 (0.88–1.06). 26 cases had a residual pneumothorax after drainage (24.5%), the CD was located by CUS in 31%, the CDI was 0.76 (0.6–0.93),
p
50°) of the CD, the risk ratio for pneumothorax was not significant (
p
|
| doi_str_mv | 10.1186/s13089-022-00296-0 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_aa383c8c12544dacbc632ef6a3e26be0</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_aa383c8c12544dacbc632ef6a3e26be0</doaj_id><sourcerecordid>2737471245</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-577bb315a1c98a3bdfa13b100a748120cc421907451937034917da6c73a554c63</originalsourceid><addsrcrecordid>eNp9ks1q3DAUhU1poCHNC2Ql6KYbN_qzZC9L6M9AoJsUuhPX8vWMBo_kSjJJnqkvWc04NCWLrK6ke86ne-FU1RWjnxhr1XVigrZdTTmvKeWdqumb6pw3XNZt1-q3_53fVZcp7WlRMcW6Rp1XfzY-Y5wnXCJMZAoWsguehJHYHaZMhgiuXD1ZphwhhcUPBB_stAyYyOxxOYS8CxEeCJQOpBSsg1x69y7vCBTiPRlwGxFfMscQMRVrRu_89vhF3mGhlHFCPYdUqgvxyfKrjvD4vjobYUp4-VQvqp9fv9zdfK9vf3zb3Hy-ra1UPNeN1n0vWAPMdi2IfhiBiZ5RClq2jFNrJWcd1bJhndBUyI7pAZTVAppGWiUuqs3KHQLszRzdAeKjCeDM6SHErYGYnZ3QAIhW2NYy3kg5gO2LneOoQCBXPdLC-riy5hh-L2UVc3DJ4jSBx7Akw7XQUjMumyL98EK6D0v0ZdOTirdSMV5UfFXZGFKKOP4bkFFzjINZ42BKHMwpDuY4hVhNqYj9FuMz-hXXX1sWunE</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2737284612</pqid></control><display><type>article</type><title>Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray</title><source>Publicly Available Content Database</source><source>Springer Nature - SpringerLink Journals - Fully Open Access </source><source>PubMed Central</source><source>Coronavirus Research Database</source><creator>Maly, Michal ; Mokotedi, Masego Candy ; Svobodova, Eva ; Flaksa, Marek ; Otahal, Michal ; Stach, Zdenek ; Rulisek, Jan ; Brozek, Tomas ; Porizka, Michal ; Balik, Martin</creator><creatorcontrib>Maly, Michal ; Mokotedi, Masego Candy ; Svobodova, Eva ; Flaksa, Marek ; Otahal, Michal ; Stach, Zdenek ; Rulisek, Jan ; Brozek, Tomas ; Porizka, Michal ; Balik, Martin</creatorcontrib><description>Background
The role of chest drain (CD) location by bedside imaging methods in the diagnosis of pneumothorax has not been explored in a prospective study yet.
Methods
Covid-19 ARDS patients with pneumothorax were prospectively monitored with chest ultrasound (CUS) and antero-posterior X-ray (CR) performed after drainage in the safe triangle. CD foreshortening was estimated as a decrease of chest drain index (CDI = length of CD in chest taken from CR/depth of insertion on CD scale + 5 cm). The angle of inclination of the CD was measured between the horizontal line and the CD at the point where it enters pleural space on CR.
Results
Of the total 106 pneumothorax cases 80 patients had full lung expansion on CUS, the CD was located by CUS in 69 (86%), the CDI was 0.99 (0.88–1.06). 26 cases had a residual pneumothorax after drainage (24.5%), the CD was located by CUS in 31%, the CDI was 0.76 (0.6–0.93),
p
< 0.01. The risk ratio for a pneumothorax in a patient with not visible CD between the pleural layers on CUS and an associated low CDI on CR was 5.97,
p
˂0.0001. For the patients with a steep angle of inclination (> 50°) of the CD, the risk ratio for pneumothorax was not significant (
p
< 0.17). A continued air leak from the CD after drainage is related to the risk for a residual pneumothorax (RR 2.27,
p
= 0.003).
Conclusion
Absence of a CD on CUS post drainage, low CDI on CR and continuous air leak significantly associate with residual occult pneumothorax which may evade diagnosis on an antero-posterior CR.</description><identifier>ISSN: 2524-8987</identifier><identifier>EISSN: 2524-8987</identifier><identifier>DOI: 10.1186/s13089-022-00296-0</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acute respiratory distress syndrome ; Barotrauma ; Chest ; Chest ultrasound ; Chest X-ray ; Covid-19 ; Critical Care Medicine ; Diagnosis ; Diagnostic Radiology ; Emergency Medicine ; Imaging ; Inclination angle ; Intensive ; Interventional Radiology ; Lungs ; Medicine ; Medicine & Public Health ; Pneumothorax ; Radiology ; Risk ; Short Communication ; Thorax ; Ultrasonic imaging ; Ultrasound ; X-rays</subject><ispartof>The ultrasound journal, 2022-11, Vol.14 (1), p.45-45, Article 45</ispartof><rights>The Author(s) 2022</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-577bb315a1c98a3bdfa13b100a748120cc421907451937034917da6c73a554c63</citedby><cites>FETCH-LOGICAL-c462t-577bb315a1c98a3bdfa13b100a748120cc421907451937034917da6c73a554c63</cites><orcidid>0000-0003-1864-2143</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2737284612/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2737284612?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,25753,27924,27925,37012,37013,38516,43895,44590,74412,75126</link.rule.ids></links><search><creatorcontrib>Maly, Michal</creatorcontrib><creatorcontrib>Mokotedi, Masego Candy</creatorcontrib><creatorcontrib>Svobodova, Eva</creatorcontrib><creatorcontrib>Flaksa, Marek</creatorcontrib><creatorcontrib>Otahal, Michal</creatorcontrib><creatorcontrib>Stach, Zdenek</creatorcontrib><creatorcontrib>Rulisek, Jan</creatorcontrib><creatorcontrib>Brozek, Tomas</creatorcontrib><creatorcontrib>Porizka, Michal</creatorcontrib><creatorcontrib>Balik, Martin</creatorcontrib><title>Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray</title><title>The ultrasound journal</title><addtitle>Ultrasound J</addtitle><description>Background
The role of chest drain (CD) location by bedside imaging methods in the diagnosis of pneumothorax has not been explored in a prospective study yet.
Methods
Covid-19 ARDS patients with pneumothorax were prospectively monitored with chest ultrasound (CUS) and antero-posterior X-ray (CR) performed after drainage in the safe triangle. CD foreshortening was estimated as a decrease of chest drain index (CDI = length of CD in chest taken from CR/depth of insertion on CD scale + 5 cm). The angle of inclination of the CD was measured between the horizontal line and the CD at the point where it enters pleural space on CR.
Results
Of the total 106 pneumothorax cases 80 patients had full lung expansion on CUS, the CD was located by CUS in 69 (86%), the CDI was 0.99 (0.88–1.06). 26 cases had a residual pneumothorax after drainage (24.5%), the CD was located by CUS in 31%, the CDI was 0.76 (0.6–0.93),
p
< 0.01. The risk ratio for a pneumothorax in a patient with not visible CD between the pleural layers on CUS and an associated low CDI on CR was 5.97,
p
˂0.0001. For the patients with a steep angle of inclination (> 50°) of the CD, the risk ratio for pneumothorax was not significant (
p
< 0.17). A continued air leak from the CD after drainage is related to the risk for a residual pneumothorax (RR 2.27,
p
= 0.003).
Conclusion
Absence of a CD on CUS post drainage, low CDI on CR and continuous air leak significantly associate with residual occult pneumothorax which may evade diagnosis on an antero-posterior CR.</description><subject>Acute respiratory distress syndrome</subject><subject>Barotrauma</subject><subject>Chest</subject><subject>Chest ultrasound</subject><subject>Chest X-ray</subject><subject>Covid-19</subject><subject>Critical Care Medicine</subject><subject>Diagnosis</subject><subject>Diagnostic Radiology</subject><subject>Emergency Medicine</subject><subject>Imaging</subject><subject>Inclination angle</subject><subject>Intensive</subject><subject>Interventional Radiology</subject><subject>Lungs</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pneumothorax</subject><subject>Radiology</subject><subject>Risk</subject><subject>Short Communication</subject><subject>Thorax</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><subject>X-rays</subject><issn>2524-8987</issn><issn>2524-8987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9ks1q3DAUhU1poCHNC2Ql6KYbN_qzZC9L6M9AoJsUuhPX8vWMBo_kSjJJnqkvWc04NCWLrK6ke86ne-FU1RWjnxhr1XVigrZdTTmvKeWdqumb6pw3XNZt1-q3_53fVZcp7WlRMcW6Rp1XfzY-Y5wnXCJMZAoWsguehJHYHaZMhgiuXD1ZphwhhcUPBB_stAyYyOxxOYS8CxEeCJQOpBSsg1x69y7vCBTiPRlwGxFfMscQMRVrRu_89vhF3mGhlHFCPYdUqgvxyfKrjvD4vjobYUp4-VQvqp9fv9zdfK9vf3zb3Hy-ra1UPNeN1n0vWAPMdi2IfhiBiZ5RClq2jFNrJWcd1bJhndBUyI7pAZTVAppGWiUuqs3KHQLszRzdAeKjCeDM6SHErYGYnZ3QAIhW2NYy3kg5gO2LneOoQCBXPdLC-riy5hh-L2UVc3DJ4jSBx7Akw7XQUjMumyL98EK6D0v0ZdOTirdSMV5UfFXZGFKKOP4bkFFzjINZ42BKHMwpDuY4hVhNqYj9FuMz-hXXX1sWunE</recordid><startdate>20221117</startdate><enddate>20221117</enddate><creator>Maly, Michal</creator><creator>Mokotedi, Masego Candy</creator><creator>Svobodova, Eva</creator><creator>Flaksa, Marek</creator><creator>Otahal, Michal</creator><creator>Stach, Zdenek</creator><creator>Rulisek, Jan</creator><creator>Brozek, Tomas</creator><creator>Porizka, Michal</creator><creator>Balik, Martin</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><general>SpringerOpen</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1864-2143</orcidid></search><sort><creationdate>20221117</creationdate><title>Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray</title><author>Maly, Michal ; Mokotedi, Masego Candy ; Svobodova, Eva ; Flaksa, Marek ; Otahal, Michal ; Stach, Zdenek ; Rulisek, Jan ; Brozek, Tomas ; Porizka, Michal ; Balik, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-577bb315a1c98a3bdfa13b100a748120cc421907451937034917da6c73a554c63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acute respiratory distress syndrome</topic><topic>Barotrauma</topic><topic>Chest</topic><topic>Chest ultrasound</topic><topic>Chest X-ray</topic><topic>Covid-19</topic><topic>Critical Care Medicine</topic><topic>Diagnosis</topic><topic>Diagnostic Radiology</topic><topic>Emergency Medicine</topic><topic>Imaging</topic><topic>Inclination angle</topic><topic>Intensive</topic><topic>Interventional Radiology</topic><topic>Lungs</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pneumothorax</topic><topic>Radiology</topic><topic>Risk</topic><topic>Short Communication</topic><topic>Thorax</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><topic>X-rays</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maly, Michal</creatorcontrib><creatorcontrib>Mokotedi, Masego Candy</creatorcontrib><creatorcontrib>Svobodova, Eva</creatorcontrib><creatorcontrib>Flaksa, Marek</creatorcontrib><creatorcontrib>Otahal, Michal</creatorcontrib><creatorcontrib>Stach, Zdenek</creatorcontrib><creatorcontrib>Rulisek, Jan</creatorcontrib><creatorcontrib>Brozek, Tomas</creatorcontrib><creatorcontrib>Porizka, Michal</creatorcontrib><creatorcontrib>Balik, Martin</creatorcontrib><collection>SpringerOpen</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>The ultrasound journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maly, Michal</au><au>Mokotedi, Masego Candy</au><au>Svobodova, Eva</au><au>Flaksa, Marek</au><au>Otahal, Michal</au><au>Stach, Zdenek</au><au>Rulisek, Jan</au><au>Brozek, Tomas</au><au>Porizka, Michal</au><au>Balik, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray</atitle><jtitle>The ultrasound journal</jtitle><stitle>Ultrasound J</stitle><date>2022-11-17</date><risdate>2022</risdate><volume>14</volume><issue>1</issue><spage>45</spage><epage>45</epage><pages>45-45</pages><artnum>45</artnum><issn>2524-8987</issn><eissn>2524-8987</eissn><abstract>Background
The role of chest drain (CD) location by bedside imaging methods in the diagnosis of pneumothorax has not been explored in a prospective study yet.
Methods
Covid-19 ARDS patients with pneumothorax were prospectively monitored with chest ultrasound (CUS) and antero-posterior X-ray (CR) performed after drainage in the safe triangle. CD foreshortening was estimated as a decrease of chest drain index (CDI = length of CD in chest taken from CR/depth of insertion on CD scale + 5 cm). The angle of inclination of the CD was measured between the horizontal line and the CD at the point where it enters pleural space on CR.
Results
Of the total 106 pneumothorax cases 80 patients had full lung expansion on CUS, the CD was located by CUS in 69 (86%), the CDI was 0.99 (0.88–1.06). 26 cases had a residual pneumothorax after drainage (24.5%), the CD was located by CUS in 31%, the CDI was 0.76 (0.6–0.93),
p
< 0.01. The risk ratio for a pneumothorax in a patient with not visible CD between the pleural layers on CUS and an associated low CDI on CR was 5.97,
p
˂0.0001. For the patients with a steep angle of inclination (> 50°) of the CD, the risk ratio for pneumothorax was not significant (
p
< 0.17). A continued air leak from the CD after drainage is related to the risk for a residual pneumothorax (RR 2.27,
p
= 0.003).
Conclusion
Absence of a CD on CUS post drainage, low CDI on CR and continuous air leak significantly associate with residual occult pneumothorax which may evade diagnosis on an antero-posterior CR.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1186/s13089-022-00296-0</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-1864-2143</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | The ultrasound journal, 2022-11, Vol.14 (1), p.45-45, Article 45 |
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| source | Publicly Available Content Database; Springer Nature - SpringerLink Journals - Fully Open Access ; PubMed Central; Coronavirus Research Database |
| subjects | Acute respiratory distress syndrome Barotrauma Chest Chest ultrasound Chest X-ray Covid-19 Critical Care Medicine Diagnosis Diagnostic Radiology Emergency Medicine Imaging Inclination angle Intensive Interventional Radiology Lungs Medicine Medicine & Public Health Pneumothorax Radiology Risk Short Communication Thorax Ultrasonic imaging Ultrasound X-rays |
| title | Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray |
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