Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones
Objective: Ultrasound is one modality to quickly diagnose pneumothoraces in critically ill patients. The bones of the chest wall often produce shadowing that can make it difficult to visualize the lung pleura. We aim to compare the ease of identifying lung sliding when viewing the pleura beneath rib...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | WFUMB Ultrasound Open |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949668324000090 |
| _version_ | 1797220476889595904 |
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| author | Patrick Kishi Michael Cirone Nicole Glowacki Michael J. Lambert Katharine M. Burns |
| author_facet | Patrick Kishi Michael Cirone Nicole Glowacki Michael J. Lambert Katharine M. Burns |
| author_sort | Patrick Kishi |
| collection | DOAJ |
| description | Objective: Ultrasound is one modality to quickly diagnose pneumothoraces in critically ill patients. The bones of the chest wall often produce shadowing that can make it difficult to visualize the lung pleura. We aim to compare the ease of identifying lung sliding when viewing the pleura beneath rib cartilage located closer to the sternum versus rib bone more laterally. Methods: On five healthy models, bilateral lung ultrasounds were performed adjacent to the sternum over rib cartilage and laterally over rib bone. The linear transducer was placed in 3 locations at each rib level. Forty-five participants were enrolled into this study to report their level of confidence in identifying lung sliding using a five-point Likert scale. The Wilcoxon signed rank test was used for statistical calculations. Results: The composite scores of lung sliding clarity were greater for images performed medially over costal cartilage compared to laterally over bone (3.5 vs 3.3, p = 0.02). When stratified by the location of cartilage or bone within the ultrasound image, lung sliding demonstrated greater clarity when the image was centered directly over cartilage versus bone (3.0 vs. 2.4, p < 0.01) and partially over cartilage versus bone, (3.4 vs 3.1, p < 0.01). No statistical difference was found when viewing images of lung sliding between cartilage versus bone (3.7 vs 3.7. p = 0.26). Conclusion: Assessing lung sliding demonstrated greater clarity when performed medially over the rib cartilage versus laterally over rib bone when ribs were within the field of view. Clinicians should consider performing ultrasounds over rib cartilage when evaluating lung sliding pathology. |
| first_indexed | 2024-04-24T12:50:09Z |
| format | Article |
| id | doaj.art-93d5632908c34e7c92e3b2364fbddcd5 |
| institution | Directory Open Access Journal |
| issn | 2949-6683 |
| language | English |
| last_indexed | 2024-04-24T12:50:09Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | WFUMB Ultrasound Open |
| spelling | doaj.art-93d5632908c34e7c92e3b2364fbddcd52024-04-06T04:40:48ZengElsevierWFUMB Ultrasound Open2949-66832024-06-0121100041Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bonesPatrick Kishi0Michael Cirone1Nicole Glowacki2Michael J. Lambert3Katharine M. Burns4Mayo Clinic, Department of Emergency Medicine, 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA; Corresponding author.Advocate Christ Medical Center, Department of Emergency Medicine, 4440 95th St, Oak Lawn, IL, 60453, USA; University of Illinois at Chicago, Department of Emergency Medicine, 808 S. Wood St, Chicago, IL, 60612, USAAdvocate Christ Medical Center, Department of Emergency Medicine, 4440 95th St, Oak Lawn, IL, 60453, USAAdvocate Christ Medical Center, Department of Emergency Medicine, 4440 95th St, Oak Lawn, IL, 60453, USAAdvocate Christ Medical Center, Department of Emergency Medicine, 4440 95th St, Oak Lawn, IL, 60453, USA; University of Illinois at Chicago, Department of Emergency Medicine, 808 S. Wood St, Chicago, IL, 60612, USAObjective: Ultrasound is one modality to quickly diagnose pneumothoraces in critically ill patients. The bones of the chest wall often produce shadowing that can make it difficult to visualize the lung pleura. We aim to compare the ease of identifying lung sliding when viewing the pleura beneath rib cartilage located closer to the sternum versus rib bone more laterally. Methods: On five healthy models, bilateral lung ultrasounds were performed adjacent to the sternum over rib cartilage and laterally over rib bone. The linear transducer was placed in 3 locations at each rib level. Forty-five participants were enrolled into this study to report their level of confidence in identifying lung sliding using a five-point Likert scale. The Wilcoxon signed rank test was used for statistical calculations. Results: The composite scores of lung sliding clarity were greater for images performed medially over costal cartilage compared to laterally over bone (3.5 vs 3.3, p = 0.02). When stratified by the location of cartilage or bone within the ultrasound image, lung sliding demonstrated greater clarity when the image was centered directly over cartilage versus bone (3.0 vs. 2.4, p < 0.01) and partially over cartilage versus bone, (3.4 vs 3.1, p < 0.01). No statistical difference was found when viewing images of lung sliding between cartilage versus bone (3.7 vs 3.7. p = 0.26). Conclusion: Assessing lung sliding demonstrated greater clarity when performed medially over the rib cartilage versus laterally over rib bone when ribs were within the field of view. Clinicians should consider performing ultrasounds over rib cartilage when evaluating lung sliding pathology.http://www.sciencedirect.com/science/article/pii/S2949668324000090 |
| spellingShingle | Patrick Kishi Michael Cirone Nicole Glowacki Michael J. Lambert Katharine M. Burns Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones WFUMB Ultrasound Open |
| title | Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones |
| title_full | Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones |
| title_fullStr | Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones |
| title_full_unstemmed | Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones |
| title_short | Comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones |
| title_sort | comparing pulmonary ultrasound findings when viewing lung pleura beneath costal cartilage compared to costal bones |
| url | http://www.sciencedirect.com/science/article/pii/S2949668324000090 |
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