Pneumothorax: Immediate ultrasound diagnosis in the critical patient

Espigares López, M.I.; Meléndez Leal, E.; Pernia Romero, A.; Torres Morera, L.M.

doi:10.1016/j.redare.2018.09.006

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"apellidos" => "Torres Morera" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica de Anestesiología y Reanimación, Hospital Universitario Puerta del Mar, Cádiz, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumotórax: diagnóstico ecográfico inmediato en el paciente crítico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1031 "Ancho" => 2500 "Tamanyo" => 398019 ] ] "descripcion" => array:1 [ "en" => "(a) M-mode ultrasound image of pneumothorax in the left lung; 1: ‘stratosphere sign’ or ‘bar code’, represented by horizontal hyperechoic parallel lines; 3: reverberation artefacts, or A-lines; (b) M-mode ultrasound image of the right lung; 2: “Sea shore sign”; 3: A-lines." ] ] ] "textoCompleto" => "We describe pneumothorax in a patient in the postanaesthesia care unit with acute respiratory distress after placement of a resynchronisation device associated with a defibrillator. Diagnostic ultrasound gives highly sensitive real-time results, although it can also give false positives. Our patient was in the supine position and breathing spontaneously. We used a convex transducer (2–5MHz) to evaluate underlying pleural line artefacts in M mode in the upper and lower fields. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> (left pneumothorax) shows hyperechoic horizontal artifacts called “stratosphere sign” or “bar code”. This sign, which is not pathognomonic, only indicates lung immobility. It can appear in selective intubation, apnoea, severe bronchospasm, pleurodesis, hypoventilation, etc. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b (healthy right lung) shows 2 areas that make up the “sea-shore sign”: the upper area, with horizontal lines (the sea) and the lower one, well aerated parenchyma, which has a granulated appearance (sand). 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ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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Vol. 65. Issue 9.