title: Ultrasound artifacts mimicking pleural sliding after pneumonectomy.
abstract: OBJECTIVE
  To determine the presence of pleural sliding on chest ultrasonography (US) in a series of patients admitted to a surgical intensive care unit (SICU).
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  16-bed SICU of a University hospital.
  
  
  METHODS
  8 patients (7 men, 1 woman), aged 64 - 73 years (mean 67.5 yrs). Seven patients underwent pneumonectomy for pulmonary neoplasms; one patient underwent an atypical lung resection after having undergone a pneumonectomy one year before.
  
  
  METHODS
  None.
  
  
  METHODS
  Chest ultrasounds were performed during mechanical ventilation and spontaneous ventilation after endotracheal tube removal. In both examinations, pleural sliding was searched bilaterally in brightness mode (B-mode) and motion mode (M-mode) on the anterior thoracic wall in the least gravitationally dependent areas.
  
  
  RESULTS
  During mechanical ventilation, pleural sliding was always absent on the side of the pneumonectomy and present on the other side. During spontaneous ventilation, some artifacts mimicking pleural sliding were noted on the side of the pneumonectomy both in B-mode and M-mode (presence of the seashore sign) in all patients, except for the one patient who had undergone a pneumonectomy one year earlier. Those artifacts became more pronounced during deep breaths.
  
  
  CONCLUSIONS
  Ultrasound artifacts mimicking pleural sliding may be observed in the absence of the lung and may originate from the activity of intercostal muscles since they become more evident during deep breathing.
authors.affiliation: Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy. Electronic address: f.cavaliere@rm.unicatt.it.
authors.forename: Franco
authors.initials: F
authors.lastname: Cavaliere
authors.affiliation: Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Zamparelli
authors.affiliation: Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors.forename: Maurizio P
authors.initials: MP
authors.lastname: Soave
authors.affiliation: Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gargaruti
authors.affiliation: Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Scapigliati
authors.affiliation: Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Paulis
mesh_terms: D000368:Aged; D016477:Artifacts; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging*; D011013:Pneumonectomy; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012121:Respiration, Artificial; D014463:Ultrasonography
keywords: Chest ultrasound; Pleural siding; Pneumonectomy; Pneumothorax; Sliding sign