Primary spontaneous pneumothorax (PSP) is a common medical condition in the emergency department. Clinically stable patients with large pneumothoraces usually undergo chest tube drainage. During the course of hospital stay, several chest X-rays are ordered at various time points. Because the number of chest X-rays during diagnosis and management of PSP can be quite high and lung ultrasound has a proven efficacy for the assessment of lung re-expansion, we decided to investigate the use of lung ultrasound for the management and decision-making regarding chest drains for PSP.
Material and methods
A total of 25 patients with PSP were evaluated. A comparison between chest X-rays and lung ultrasound was made at four different time points during patient hospitalization (T1—immediately after drainage, T2–third or fourth post-drainage day, T3—before chest tube removal, T4—after chest tube removal). The rate of agreement between the two investigations was analyzed, as their result impacts decision-making regarding chest tube management and removal.
Overall, positive and negative agreements were high in all time points, except time point 3. Calculated p values using Fisher’s and Barnard’s test were also good for time points 1, 2, and 4 (< 0.05).
For all time points except the third, we can safely reject the null hypothesis, thereby arriving at the conclusion that lung ultrasound can substitute chest X-rays after tube drainage of PSP.