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High correlation of lung ultrasound and chest X-ray after tube drainage in patients with primary spontaneous pneumothorax: can we omit X-rays for tube management?

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Summary

Background

Primary spontaneous pneumothorax (PSP) is a common medical condition in the emergency department. Clinically stable patients with large pneumothoraces usually undergo chest tube drainage. During the course of hospital stay, several chest X-rays are ordered at various time points. Because the number of chest X-rays during diagnosis and management of PSP can be quite high and lung ultrasound has a proven efficacy for the assessment of lung re-expansion, we decided to investigate the use of lung ultrasound for the management and decision-making regarding chest drains for PSP.

Material and methods

A total of 25 patients with PSP were evaluated. A comparison between chest X-rays and lung ultrasound was made at four different time points during patient hospitalization (T1—immediately after drainage, T2–third or fourth post-drainage day, T3—before chest tube removal, T4—after chest tube removal). The rate of agreement between the two investigations was analyzed, as their result impacts decision-making regarding chest tube management and removal.

Results

Overall, positive and negative agreements were high in all time points, except time point 3. Calculated p values using Fisher’s and Barnard’s test were also good for time points 1, 2, and 4 (< 0.05).

Conclusions

For all time points except the third, we can safely reject the null hypothesis, thereby arriving at the conclusion that lung ultrasound can substitute chest X-rays after tube drainage of PSP.

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Authors and Affiliations

  1. Surgery Department, Carol Davila University of Pharmacy, Pantelimon street, no. 340–342, 1st floor, Bucharest, Romania

    V. Constantin MD, PhD, A. C. Carap MD, S. Bobic, E. Brătilă & B. Socea

  2. Surgery Department, Sfântul Pantelimon Emergency Clinical Hospital, Pantelimon street, no. 340–342, 1st floor, Bucharest, Romania

    V. Constantin MD, PhD, A. C. Carap MD, L. Zaharia MD, S. Bobic & B. Socea

  3. Urology Department, Hospital Clinic, Barcelona, Spain

    A. Ciudin

  4. Institute of Solid Mechanics, Bucharest, Romania

    V. Vlădăreanu

Authors
  1. V. Constantin MD, PhD
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  2. A. C. Carap MD
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  3. L. Zaharia MD
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  4. S. Bobic
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  5. A. Ciudin
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  6. E. Brătilă
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  7. V. Vlădăreanu
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  8. B. Socea
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Corresponding author

Correspondence to A. C. Carap MD.

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Constantin, V., Carap, A., Zaharia, L. et al. High correlation of lung ultrasound and chest X-ray after tube drainage in patients with primary spontaneous pneumothorax: can we omit X-rays for tube management?. Eur Surg 47, 175–180 (2015). https://doi.org/10.1007/s10353-015-0333-9

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  • DOI: https://doi.org/10.1007/s10353-015-0333-9

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