Advantages of Cardiopulmonary Ultrasound in Post-Cardiopulmonary Resuscitation Tension Pneumothorax

SONOSIM SUMMARY: This case report details the use of a modified rapid ultrasound (US) protocol to assess a 78-year-old woman suspected of tension pneumothorax following resuscitation. A lung US exam was performed but was nondiagnostic due to subcutaneous air obstructing pleural views. Parasternal and apical cardiac views were also obstructed; however, inferior vena cava (IVC) and subcostal US views showed a dilated IVC and a hyperdynamic right ventricle. An emergent chest tube was placed in the right pleural space, and the patient’s condition improved dramatically. This report acknowledges the potential difficulties associated with recognizing tension pneumothorax using pleural US and concludes that it is critical for bedside physicians to be capable of recognizing the indications of tension pneumothorax by obtaining IVC and subcostal US views.

Lanks CW, Correa V. Advantages of cardiopulmonary ultrasound in post-cardiopulmonary resuscitation tension pneumothorax. J Ultrasound Med. 2018 Apr;37(4):819-822.

Abstract

Ultrasound has become a rapid, safe, and easy-to-use tool for anesthesiologists. It reduces complications, morbidity, and mortality, especially in patients with anatomic abnormalities in whom a traditional approach may be both difficult and risky. We report two cases of symptomatic patients with a difficult airway due to displacement of the trachea by a neck mass. Real-time ultrasound imaging was performed for percutaneous dilatational tracheostomies, identifying important structures, without any complications.

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SonoSim Keywords: Ultrasound Education, Post-Cardiopulmonary Resuscitation Tension Pneumothorax, Point-of-Care Ultrasonography