TITLE:
The Role of Ultrasound and Air Leak Measurement in Assessing Lung Expansion after Thoracic Surgery
AUTHORS:
Abraham Chavarín, Laureano Molins, Jose M. Mier, Juan J. Fibla, Cristina Izquierdo-Vidal, Cristina Simon, Angela Guirao, Jorge Hernandez
KEYWORDS:
Thoracic Surgery, Pneumothorax, Ultrasonography, Lung Expansion, Chest Radiograph
JOURNAL NAME:
Surgical Science,
Vol.6 No.8,
July
30,
2015
ABSTRACT: Objective: To determine if lung ultrasound semiology is applicable to the
post-surgical hemithorax, and its value in the evaluation of lung expansion in
the postoperative period when paired with the use of digital chest drain
systems. Methods: Prospective observational study including all patients
undergoing thoracic surgery from June 2012 to March 2013. Patients undergoing
pleurodesis or hemodynamically unstable were not considered candidates. Final
inclusion in the study was based on the availability of digital chest drain
system. A transthoracic lung ultrasound evaluation of the anterior and anterolateral
windows was performed 20 minutes after chest drain placement. Presence or not
of lung sliding and air leak values taken from the digital chest drain system
were recorded. Data were submitted to a binomial classification test for
analysis. Results: Forty-nine patients were included, yielding a total of 64
hemithoraces. Lung sliding was seen in 53 cases (82.8%), and an air leak value
of 20 ml/min or less in 56 cases (87.5%). Sensitivity was 92.8% (95% CI: 82.6%
to 97.9%) and specificity 87.5% (95% CI: 47.3% to 97.9%). Positive predictive
value was 98.1%, and negative predictive value was 63.6%. Conclusions:
Transthoracic lung ultrasound is a useful technique that can complement the use
of digital chest drain systems in the evaluation of post-surgical lung
expansion. The incorporation of lung ultrasound can greatly reduce the need for
chest radiographs in thoracic surgery departments.