Abstract
BACKGROUND: In recent years, acute respiratory failure conditions have been evaluated using ultrasonography (US) in emergency and critical care settings. It is helpful for determining the cause of a number of problems involving the pleura and lung, including pneumothorax, alveolar interstitial syndrome, and pleural effusion (PTX). The US has good sensitivity and specificity for the diagnosis of various disorders in addition to being reproducible and timely. Chest X-rays are the method for bedside evaluation of PTX that is most frequently employed (CXR). However, CXR has a limited ability to diagnose PTX, particularly in cases with occult PTX and when the patient is supine. The gold standard for PT evaluation is computed tomography (CT), although it has limitations because to excessive radiation exposure and issues with patient safety during transit.
AIM: The aim of this study was to assess the ability of emergency department clinicians to perform bedside Ultrasonography to detect and assess the size of the pneumothorax in patients.
MATERIAL AND METHOD: The Department of Radiology has carried out this prospective study. Patients with multiple injuries were recruited, whether they were in the emergency intensive care unit (EICU) or the resuscitation room. All of the patients who were analyzed in this study underwent CT scans in addition to CXR and US tests. Only patients who had CT scans were included in studies that had patients with differential verifications. Only individuals who had been assessed for pneumothorax were included in a study if they were also screened for other conditions in addition to pneumothorax. 136 patients who had experienced numerous traumas underwent ultrasonography. Patients who agreed to participate in the trial with their guardians’ permission provided signed informed consent.
RESULTS: 136 patients who had experienced numerous traumas underwent ultrasonography. Twenty of them were disqualified due to a lack of a chest CT or a three-hour gap between the US and CT scan. There were 106 patients total, 20 in the resuscitation room, 86 in the intensive care unit, and 90 men and 16 women. The age distribution was 40±12 years. The majority of patients (51.5%), followed by falls (17.7%), crush injuries (8.6%), and other causes (6.2%), all experienced blunt trauma. 51.5% of the patient received mechanical ventilation. Nine patients had minor pneumothoraxes, six had medium-sized pneumothoraxes, and three had big pneumothoraxes in 18 true positive patients whose diagnoses were made by the US and confirmed by CT. One of the three false-positive patients experienced severe late acute respiratory distress syndrome, while the other two experienced pleural adhesion.
CONCLUSION: US is a fresh method for assessing PTX, with benefits including quickness, high accuracy, and high reliability. The usual training programs for doctors working in emergency and critical care settings should include the US abilities. There are numerous areas of current research because lung ultrasonography is a relatively young technology. For instance, new indications are still being recorded and described. The method for quantifying PTX size is still being researched. Moreover, cases of PTX diagnosis in patients undergoing mechanical ventilation or who have significant lung bullae are being recorded. For the diagnosis of pneumothorax and measurement of its size in patients with repeated trauma, clinician-performed US is a reliable tool.
KEYWORDS: Ultrasonography (US); Pneumothorax (PTX); Lung Point Computed Tomography (CT), Lung Sliding, Lung Point.