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Owen GS, Harmon KA, Sullivan GA, Petit HJ, Westrick J, Cameron JR, Gulack BC, Shah AN. Methods of measurement for pneumothorax in pediatric patients: a systematic review. Pediatr Surg Int 2024; 40:77. [PMID: 38472473 DOI: 10.1007/s00383-024-05640-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/14/2024]
Abstract
Accurate measurement of pneumothorax (PTX) size is necessary to guide clinical decision making; however, there is no consensus as to which method should be used in pediatric patients. This systematic review seeks to identify and evaluate the methods used to measure PTX size with CXR in pediatric patients. A systematic review of the literature through 2021 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was conducted using the following databases: Ovid/MEDLINE, Scopus, Cochrane Database of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Original research articles that included pediatric patients (< 18 years old) and outlined the PTX measurement method were included. 45 studies were identified and grouped by method (Kircher and Swartzel, Rhea, Light, Collins, Other) and societal guideline used. The most used method was Collins (n = 16; 35.6%). Only four (8.9%) studies compared validated methods. All found the Collins method to be accurate. Seven (15.6%) studies used a standard classification guideline and 3 (6.7%) compared guidelines and found significant disagreement between them. Pediatric-specific measurement guidelines for PTX are needed to establish consistency and uniformity in both research and clinical practice. Until there is a better method, the Collins method is preferred.
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Affiliation(s)
- Grant S Owen
- Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - Kelly A Harmon
- Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - Gwyneth A Sullivan
- Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, 1653 W. Congress Parkway, Suite 794, Chicago, IL, 60612, USA
| | - Hayley J Petit
- Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - Jennifer Westrick
- Library of Rush Medical Center, Rush University Medical Center, Chicago, IL, USA
| | - James R Cameron
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Brian C Gulack
- Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, 1653 W. Congress Parkway, Suite 794, Chicago, IL, 60612, USA
| | - Ami N Shah
- Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, 1653 W. Congress Parkway, Suite 794, Chicago, IL, 60612, USA.
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Usefulness of the Electrocardiogram in a Patient Presenting with Right-Sided Pneumothorax and Presyncope. Diagnostics (Basel) 2021; 11:diagnostics11061069. [PMID: 34200664 PMCID: PMC8229150 DOI: 10.3390/diagnostics11061069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 11/17/2022] Open
Abstract
We present the case of a 71-year-old man with history of smoking, pulmonary emphysema, hypertension, multivessel coronary artery disease and prior coronary artery bypass graft surgery who presented with spontaneous right-sided pneumothorax associated with phasic changes of the QRS amplitude on the electrocardiogram. While several case reports have described QRS amplitude changes associated with left-sided pneumothorax, reports of phasic ECG changes in right-sided pneumothorax are exceedingly rare. Such changes, when present in a patient with sudden onset chest pain and dyspnea, should prompt a diagnostic workup for possible pneumothorax.
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