title: A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding.
abstract: 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.
authors.affiliation: Service de Réanimation Médicale, Hôpital Ambroise-Paré, Boulogne, France.
authors.forename: D A
authors.initials: DA
authors.lastname: Lichtenstein
authors.forename: Y
authors.initials: Y
authors.lastname: Menu
mesh_terms: 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