Most patient conditions do not a priori debilitate the sensitivity of thoracic ultrasound in thoracic surgery-a prospective comparative study

Journal of Cardiothoracic Surgery

Mark Schieren¹  Jerome Defosse¹  Frank Wappler¹  Benjamin Marks²  Thomas Galetin³  Erich Stoelben³  Aris Koryllos³  Julika Merres³  Yves Haffke³ 

[1] Department of Anaesthesiology and Intensive Care Medicine, University Witten/Herdecke, Medical Centre Cologne-Merheim, Cologne, Germany;Department of Radiology, University Witten/Herdecke, Medical Centre Cologne-Merheim, Cologne, Germany;Lungclinic, Thoracic Surgery, University Witten/Herdecke, Medical Centre Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany;

关键词: Lung ultrasound;    Pneumothorax;    Thoracic surgery;    Sensitivity;   

DOI  :  10.1186/s13019-021-01454-6

来源: Springer

【 摘 要 】

BackgroundThe few existing studies on the accuracy of lung ultrasound in the detection of a postoperative pneumothorax after thoracic surgery differ in the sonographic technique and the inclusion criteria. Several conditions are considered unfavourable in the sonographic examination of the lung. We aim to test these conditions for their impact on the diagnostic accuracy of lung ultrasound.MethodsWe compared lung ultrasound and chest roentgenograms for the detection of a pneumothorax after lung-resecting surgery in two prospective trials (register ID DRKS00014557 and DRKS00020216). The ultrasound examiners and radiologists were blinded towards the corresponding findings. We performed posthoc subgroup analyses to determine the influence of various patient or surgery related conditions on the sensitivity and specificity of ultrasound in the detection of pneumothorax.ResultsWe performed 340 examinations in 208 patients. The covariates were age, gender, body mass index, smoking status, severity of chronic obstructive pulmonary disease, previous ipsilateral operation or irradiation, thoracotomy, postoperative skin emphysema, indwelling chest tube and X-ray in supine position. In univariate analysis, an indwelling chest-tube was associated with a higher sensitivity (58%, p = 0.04), and a postoperative subcutaneous emphysema with a lower specificity (73% vs. 88%, p = 0.02). None of the other subgroups differed in sensitivity or specificity from the total population .ConclusionsMost of the patient- or surgery related conditions usually considered unfavourable for lung ultrasound did not impair the sensitivity or specificity of lung ultrasound. Further studies should not excluce patients with these conditions, but test the accuracy under routine conditions.Trial registrationDRKS, DRKS00014557, registered 06/09/2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014557 and DRKS00020216, registered 03/12/2019, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020216

【 授权许可】

CC BY