• Revista clínica española · May 2021

    Validity of thoracic ultrasonography to rule out iatrogenic pneumothorax performed by pulmonologists without experience in this procedure.

    • C Ramos Hernández, M Núñez Delgado, M Botana Rial, C Mouronte Roibás, V Leiro Fernández, C Vilariño Pombo, R Tubío Pérez, M Nuñez Fernández, and A Fernández Villar.
    • Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España. Electronic address: cristina.ramos.hernandez@sergas.es.
    • Rev Clin Esp. 2021 May 1; 221 (5): 258263258-263.

    IntroductionUltrasonography has been shown to be a useful tool for diagnosing pneumothorax in the hands of experts. After performing bronchopleural procedures, the recommendation is to perform chest radiography to rule out complications. Our objective was to determine the validity of lung ultrasound, conducted by pulmonologists without experience in this procedure, to rule out pneumothorax after invasive procedures.Material And MethodsOur prospective observational study consecutively included patients who underwent transbronchial lung biopsy (TBLB), therapeutic thoracentesis (TT) and/or transparietal pleural biopsies (PB) for whom subsequent chest radiography to rule out complications was indicated. In all cases, the same pulmonologist who performed the technique performed an ultrasound immediately after the procedure. A diagnosis of pneumothorax was considered in the presence of a lung point or the combination of the following signs: absence of pleural sliding, absence of B-lines and presence of the "barcode" sign.ResultsWe included 275 procedures (149 TBLBs, 36 BPs, 90 TTs), which resulted in 14 (5.1%) iatrogenic pneumothoraxes. Ultrasonography presented a sensitivity of 78.5%, a specificity of 85% and positive and negative predictive value of 22% and 98.6%, respectively. Ultrasonography did not help detect the presence of 3 pneumothoraxes, one of which required chest drainage, but adequately diagnosed 2 pneumothoraxes that were not identified in the initial radiography.ConclusionsLung ultrasound performed by pulmonologists at the start of their training helps rule out pneumothorax with a negative predictive value of 98.6%, thereby avoiding unnecessary radiographic control studies in a considerable number of cases.Copyright © 2020 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

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