الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
Abstract
Background:
Pneumothorax is known as the presence of air within the pleural space, it represent a common problem in the Intensive Care Units as the result of central venous line insertion.
PTX represents an important cause of respiratory failure that requires urgent intervemtion to avoid catastrophic consequences.
Traditionally, chest X Ray had been the first ivestigation either to rule out or confirm the diagnosis of PTX in the case of trauma or after invasive intervention.
If there is uncertainty in regards to the results of CXR and the patient is stable, it is encouraged to lead further imaging with ultrasonography or CT scan.
Chest US use for detection of PTX has recently been used as the method of choice with physicians skilled at bedside US. US has many advantages in comparison to standard CXR and CT scan, such as being portable,lack of radiation, real-time imaging,in addition it is less time consuming, and has the ability to be easily repeated for further evaluations.
This study aims to compare between the accuracy of using bedside lung ultrasound & those for antero-posterior chest X ray for the revealing of the incidence of PTX occurrence in critically ill patients especially mechanically ventilated with central venous line.
Methods:
This study included fifty adult patients from both sexes, mechanically ventilated at least 48 hours and planned for central line insertion.
We excluded overt pneumothorax, patients requiring immediate invasive intervention, pregnancy and lactation.
Lung ultrasound was done to all patients after 30 minutes from central line insertion followed by CXR to confirm the diagnosis of pneumothorax. Pneumothorax was confirmed using CT chest.
Results:
Results showed that ultrasound is superior to chest X Ray in detection of PTX.
Ultrasound showed sensitivity of 94.87%, specificity of 81.82%, PPV of 94.87%, NPV of 21.82% and accuracy of 92.0% in detection of PTX, while Chest X Ray showed sensitivity of 76.92%, specificity of 63.64%, PPV of 88.24%, NPV of 43.75% and accuracy of 74.0% in detection of PTX.
Conclusions:
● Ultrasound represent a good diagnostic tool for the detection and diagnosis of PTX, it has the advantage of being a fast tool, high accuracy reliability.
● Ultrasound showed higher accuracy than CXR in detection of PTX in intensive care unit patients with sensitivity of 94.87%, specificity of 81.82%, PPV of 94.87%, NPV of 21.82% and accuracy of 92.0%.