Point-of-Care Ultrasound Diagnostics of the Lung - New Areas of Application in Anaesthesiology and Thoracic SurgeryStudy 2: Use of ultrasound for postoperative controls after lung resection surgery
- Conditions
- J95.80
- Registration Number
- DRKS00014557
- Lead Sponsor
- Kliniken der Stadt Köln gGmbH, Standort Merheim
- Brief Summary
Abstract Objectives: Thoracic ultrasound is superior to chest X-ray for the detection of a pneumothorax in trauma and intensive care medicine. Data regarding its use in non-cardiac thoracic surgery are scarce and contradictory. Previous studies are heterogeneous regarding sonographic methodology and patient selection. This study aimed to evaluate the accuracy of thoracic ultrasound for pneumothorax assessment after lung resecting surgery in unselected patients. Methods: SONOR (SONOgraphy vs x-Ray) is a prospective observational trial (registry-ID DRKS00014557). A total of 123 consecutive patients with lung resecting surgery received a standardized thoracic ultrasound the same day and in addition to routine chest X-rays in erect position after removal of the chest tube. The sonographer was blinded to radiological findings and vice versa. Results: Sensitivity, specificity, positive and negative predictive values of ultrasound after removing the chest tube were 0.32, 0.85, 0.54, 0.69 for any pneumothorax and 1.0, 0.82, 0.19, 1.0 for pneumothorax =3 cm. No clinically relevant pneumothorax was missed. The agreement between sonography- and routine-based therapeutic decisions was 97%. Lung pulse was the most frequently detected sign to sonographically rule out a pneumothorax. Conclusions: Postoperative thoracic ultrasound in unselected patients has a low overall sensitivity to detect a residual pneumothorax; however, its sensitivity and negative predictive values regarding clinically relevant pneumothorax are high. Test quality depends on the distinct sonographic methodology and patient selection. Anatomic differences in postsurgical and medical patients may be responsible for the contradictory results of previous trials. Studies with a larger population size are required to validate the accuracy of relevant pneumothoraces and identify appropriate selection criteria.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete
- Sex
- All
- Target Recruitment
- 136
lung resecting thoracic surgery
capable patient
consent
- Persons who are dependent on or employed by the sponsor or investigator
- Accommodation in an institution due to a court or official order
- Disable patient who is unable to understand the nature, meaning and scope of the study
- Pregnancy and lactation
Study & Design
- Study Type
- observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Sensitivity of thoracic ultrasound for postoperative pneumothorax after removal of the chest tube, controlled by X-ray.
- Secondary Outcome Measures
Name Time Method Specificity of pulmonary sonography for a pneumothorax after removal of chest tube after lung resection thoracic surgery compared to conventional chest x-ray.<br>Sensitivity and specificity of lung sonography for a pneumothorax 2 hours after lung resection thoracic surgery in the recovery room, measured at the reference of the chest tube (air leakage).<br>Sensitivity and specificity of pulmonary sonography for a pneumothorax on the first day after lung resecting surgery<br>Detection of pleural effusions<br>Detection of parenchymal changes<br>examination duration<br>Real or potential damages of the diagnostics are quantified (radiation dose)<br>Differences in the assessment of the relevance of a detected pneumothorax<br>Comparison of resources used