A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding.
OBJECTIVE
To describe and evaluate an ultrasound pattern useful in the diagnosis of pneumothorax.


METHODS
Ultrasound examination of "lung sliding," a respiratory movement visible when investigating the chest wall.


METHODS
The medical ICU of a university-affiliated hospital.


METHODS
The study group included 43 proved pneumothoraces, either by chest radiograph (n = 40) or by CT (n = 3). The control group included 68 hemithoraces in which the absence of pneumothorax was proved by CT.


METHODS
Analysis of anterior chest wall in supine patients.


RESULTS
Feasibility was 98.1%. Disappearance of "lung sliding" was observed in 100% of 41 analyzable cases of pneumothorax vs 8.8% of the hemithorax without pneumothorax (6 of 68). In this series, sensitivity was 95.3%, specificity 91.1%, and negative predictive value 100% (p < 0.001).


CONCLUSIONS
Ultrasound was a sensitive test for detection of pneumothorax, although false-positive cases were noted. The principal value of this test was that it could immediately exclude anterior pneumothorax.
Lichtenstein
D A
DA
Service de Réanimation Médicale, Hôpital Ambroise-Paré, Boulogne, France.
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D000328:Adult; D000368:Aged; D016638:Critical Illness; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000209:etiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography