Distribution of pneumothorax in the supine and semirecumbent critically ill adult

Although a number of radiologic signs of pneumothorax in the supine patient have been reported, the frequency of involvement of various pleural recesses has not been emphasized. In 88 critically ill patients with 112 pneumothoraces, the anteromedial (38%) and subpulmonic (26%) recesses were the most commonly involved in the supine and semirecumbent position. In this study, 30% of pneumothoraces were not initially detected by the clinician or radiologist, and half of these progressed to tension pneumothorax. Knowledge of the most common recesses involved in pneumothorax and aggressive use of additional radiographic views, including computed tomography, should increase detection of pneumothoraces in critically ill patients.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C P Day and N A Watson Emergency chest radiology: chest wall, pleura, lungs and diaphragm Imaging, September 1, 2006; 18(3): 111 - 121. [Abstract] [Full Text] [PDF]

				S Leigh-Smith and T Harris Tension pneumothorax--time for a re-think? Emerg. Med. J., January 1, 2005; 22(1): 8 - 16. [Abstract] [Full Text] [PDF]

				M K Harkness, A Hashim, and D Spence The "hidden" pneumothorax Emerg. Med. J., May 1, 2004; 21(3): 386 - 387. [Full Text] [PDF]

				M Henry, T Arnold, and J Harvey BTS guidelines for the management of spontaneous pneumothorax Thorax, May 1, 2003; 58(90002): ii39 - 52. [Full Text]

				K. J. Woodside, E. vanSonnenberg, K. S. Chon, D. B. Loran, I. M. Tocino, and J. B. Zwischenberger Pneumothorax in Patients With Acute Respiratory Distress Syndrome: Pathophysiology, Detection, and Treatment J Intensive Care Med, January 1, 2003; 18(1): 9 - 20. [Abstract] [PDF]

				K.-Y. Chen, J.-S. Jerng, W.-Y. Liao, L.-W. Ding, L.-C. Kuo, J.-Y. Wang, and P.-C. Yang Pneumothorax in the ICU* : Patient Outcomes and Prognostic Factors Chest, August 1, 2002; 122(2): 678 - 683. [Abstract] [Full Text] [PDF]

				K. E. Thomas, C. M. Owens, J. Britto, S. Nadel, P. Habibi, and R. Nicholson Efficacy of Chest CT in a Pediatric ICU : A Prospective Study Chest, June 1, 2000; 117(6): 1697 - 1705. [Abstract] [Full Text] [PDF]

				D. Weissberg and Y. Refaely Pneumothorax Chest, May 1, 2000; 117(5): 1279 - 1285. [Abstract] [Full Text] [PDF]

				M. J. Tobin Mechanical Ventilation N. Engl. J. Med., April 14, 1994; 330(15): 1056 - 1061. [Full Text]

				M. D. Wiener, D. N. Wiener, and C. E. Ravin Thoracic Imaging in the Intensive Care Unit J Intensive Care Med, July 1, 1989; 4(4): 149 - 165. [Abstract] [PDF]

				P. F. Grim and W. J. Keenan Two Uncommon Radiographic Signs of an Anterior Neonatal Pneumothorax: Correlated with Clinical Finding Clinical Pediatrics, September 1, 1986; 25(9): 440 - 444. [Abstract] [PDF]