Anna E Sagaser, Ashley Reeves, Tamara Arnautovic, Juan Sanchez-Esteban
{"title":"Distinction between Pneumothorax and Pneumomediastinum Using Point of Care Ultrasound (POCUS): Role of Still Lung Point.","authors":"Anna E Sagaser, Ashley Reeves, Tamara Arnautovic, Juan Sanchez-Esteban","doi":"10.1055/a-2415-5318","DOIUrl":null,"url":null,"abstract":"<p><p>The rapid identification and management of air leak syndrome in the neonatal intensive care unit is critical to prevent and/or minimize short- and long-term complications. Traditionally, chest X-ray is used to diagnose pneumothorax or pneumomediastinum. However, point-of-care ultrasound is increasingly being used for procedural and diagnostic purposes. Current ultrasound guidelines recommend specific criteria to diagnose pneumothorax in newborns including sharp A-lines, absence of B-lines, lack of shimmering of the pleural line, and the presence of a lung point. Pneumomediastinum may have similar ultrasound characteristics. In this case report, we present two cases of pneumomediastinum in newborns, describe the associated ultrasound findings, and review some of the criteria to differentiate from pneumothorax, including the presence of a still lung point. A high index of suspicion for pneumomediastinum should be maintained when using ultrasound to diagnose air leak given the overlapping sonographic features with pneumothorax. This distinction is of particular importance if evacuation of air by needle thoracentesis or the placement of a chest tube is under consideration.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 3","pages":"e239-e243"},"PeriodicalIF":0.8000,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461096/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AJP Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/a-2415-5318","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
The rapid identification and management of air leak syndrome in the neonatal intensive care unit is critical to prevent and/or minimize short- and long-term complications. Traditionally, chest X-ray is used to diagnose pneumothorax or pneumomediastinum. However, point-of-care ultrasound is increasingly being used for procedural and diagnostic purposes. Current ultrasound guidelines recommend specific criteria to diagnose pneumothorax in newborns including sharp A-lines, absence of B-lines, lack of shimmering of the pleural line, and the presence of a lung point. Pneumomediastinum may have similar ultrasound characteristics. In this case report, we present two cases of pneumomediastinum in newborns, describe the associated ultrasound findings, and review some of the criteria to differentiate from pneumothorax, including the presence of a still lung point. A high index of suspicion for pneumomediastinum should be maintained when using ultrasound to diagnose air leak given the overlapping sonographic features with pneumothorax. This distinction is of particular importance if evacuation of air by needle thoracentesis or the placement of a chest tube is under consideration.
在新生儿重症监护病房快速识别和处理漏气综合征对于预防和/或减少短期和长期并发症至关重要。传统上,胸部 X 射线用于诊断气胸或气胸膜。然而,护理点超声波越来越多地被用于程序和诊断目的。目前的超声波指南推荐了诊断新生儿气胸的具体标准,包括 A 线清晰、无 B 线、胸膜线无闪烁以及肺点的存在。气胸也可能具有类似的超声特征。在本病例报告中,我们介绍了两例新生儿气腹病例,描述了相关的超声检查结果,并回顾了与气胸鉴别的一些标准,包括是否存在静止的肺点。鉴于超声波与气胸的声像图特征重叠,在使用超声波诊断气胸时应高度怀疑气胸。如果考虑通过针刺胸腔穿刺术排空空气或放置胸管,这种区分尤为重要。