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Case Report
- Pulmonary
- Digital tomography in the diagnosis of a posterior pneumothorax in the intensive care unit
- Shauni Wellekens, Nico Buls, Johan De Mey, Vincent Van Nieuwenhove, Jeroen Cant, Joop Jonckheer
- Received December 24, 2021 Accepted February 4, 2022 Published online June 10, 2022
- DOI: https://doi.org/10.4266/acc.2021.01802 [Epub ahead of print]
- 1,775 View
- 56 Download
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Abstract
PDF - Portable chest radiography is a valuable tool in the intensive care unit. However, the supine position causes superposition of anatomical structures resulting in less reliable detection of certain abnormalities. Recently, a portable digital tomosynthesis (pDTS) prototype with a modified motorized X-ray device was developed. Our aim is to compare the diagnostic value of pDTS to standard bedside chest radiography in the diagnosis of a posterior pneumothorax. A modified motorized x-ray device was developed to perform 15 radiographic projections while translating the X-ray tube 25 cm (10 cm ramp up and 15 cm during X-ray exposure) with a total radiation dose of 0.54 mSv. This new technique of pDTS was performed in addition to standard bedside chest X-ray in a patient with a confirmed posterior hydropneumothorax. The images were compared with the standard bedside chest X-ray and computed tomography (CT) images by two experienced radiologists. The posterior hydropneumothorax previously identified with CT was visible on tomosynthesis images but not with standard bedside imaging. Combining the digital tomosynthesis technique with the portable x-ray machine could increase the diagnostic value of bedside chest radiography for the diagnosis of posterior pneumothoraces, while avoiding intrahospital transport and limiting radiation exposure compared to CT.
Original Article
- Pediatrics
- Determining the diagnostic value of tracheal intubation by palpation and auscultation methods compared to the chest X-ray method in children
- Gholamreza Masoumi, Mojtaba Mansouri, Omid Fathali
- Acute Crit Care. 2022;37(2):224-229. Published online February 3, 2022
- DOI: https://doi.org/10.4266/acc.2021.00787
- 3,265 View
- 173 Download
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Abstract
PDF
- Background
It is important to determine the proper location of tracheal tube for proper ventilation. In this study, we compared the diagnostic value of tracheal intubation with two methods of palpation and auscultation with chest X-ray (CXR) method in pediatric.
Methods
In this interventional study, 80 patients under 6 years of age were included. After tracheal intubation appropriate depth of tracheal tube was determined by auscultation and recorded, then by palpation depth of tracheal tube determined and tube was fixed. The length of the tube was calculated with the standard formula based on age. After surgery, CXR was taken and, according to the landmark, the distance from the end of the tube to the anterior lower tooth was recorded.
Results
Interclass correlation coefficient (ICC) between the palpation method and the standard method in the number of fixing tracheal intubation was 0.573, which shows the average and significant correlation between these two methods in determining the fixed number of tracheal intubation. ICC between the auscultation and the standard method in fixing tracheal intubation number was 0.430, which shows the average and significant agreement between these two methods in determining the fixed number of tracheal intubation. There is no significant relationship between sex and the average number of fixing tracheal intubation in all methods.
Conclusions
This study has shown that both palpation and auscultation methods are appropriate, but with a slightly higher palpation ICC, the palpation can be considered relatively better.
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