{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:25Z","timestamp":1756379425106,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,30]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>A 64-year-old man was intubated and ventilated for COVID-19-associated acute respiratory distress syndrome. He had a background history of chronic obstructive pulmonary disease and ischaemic heart disease. His oxygen saturations dropped rapidly to 80% on day 9 of ICU admission. Chest auscultation revealed absent breath sounds over the left upper chest which raised suspicions for pneumothorax, of which a small stable left apical pneumothorax was documented on a recent CT scan of the thorax. Point-of-care ultrasonography was performed prior to attempting chest drain insertion which demonstrated sliding pleura on the left side (GE Healthcare model: Vscan Extend\u2014display: 5 inches, 720\u00d71280 pixels resolution, sector probe\u2014broad bandwidth: 1.7\u20133.8 MHz, 24 cm penetration and linear probe\u2014broad bandwidth: 3.3\u20138 MHz, 8 cm penetration). A portable chest X-ray was obtained which demonstrated left upper lobe collapse secondary to mucus plugging. The mucus plug was successfully suctioned from the patient\u2019s airway using bedside bronchoscopy subsequently improving the patient\u2019s oxygen saturation. A follow-up chest X-ray and CT scan of the thorax demonstrated interval resolution of the left upper lobe collapse. While expansion of his existing pneumothorax was first on the list of differential diagnoses, the use of ultrasonography early in the patient\u2019s assessment ensured it was ruled out prior to attempting chest drain insertion, thus prompting the acquisition of the chest X-ray which subsequently demonstrated the left upper lobe collapse as the correct diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2020-240891","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T12:58:29Z","timestamp":1615899509000},"page":"e240891","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Use of point-of-care lung ultrasonography in the critical care setting as an aid to identifying the correct diagnosis in an acutely desaturating patient with COVID-19-related acute respiratory distress syndrome"],"prefix":"10.1136","volume":"14","author":[{"given":"Chris","family":"Lock","sequence":"first","affiliation":[{"name":"Anaesthesia, Critical Care & Pain Medicine, University Hospital Limerick, Limerick, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine M","family":"Nix","sequence":"additional","affiliation":[{"name":"Anaesthesia, Critical Care & Pain Medicine, University Hospital Limerick, Limerick, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"2025082803415687000_14.3.e240891.1","doi-asserted-by":"crossref","first-page":"P157","DOI":"10.1186\/cc9577","article-title":"Acute desaturation in intubated patients","volume":"15","author":"Myrianthefs","year":"2011","journal-title":"Crit Care"},{"key":"2025082803415687000_14.3.e240891.2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.2147\/RMI.S40095","article-title":"Impact of point-of-care ultrasound on quality of care in clinical practice","volume":"7","author":"Adhikari","year":"2014","journal-title":"Reports in Medical Imaging"},{"key":"2025082803415687000_14.3.e240891.3","unstructured":"McDermott C . Combatting COVID19 - Is Lung Ultrasound an Option? St.Emlyn\u2019s 2020 https:\/\/www.stemlynsblog.org\/combatting-covid19-is-lung-ultrasound-an-option\/"},{"key":"2025082803415687000_14.3.e240891.4","unstructured":"European Centre for disease prevention and control . Guidance for wearing and removing personal protective equipment in healthcare settings for the care of patients with suspected or confirmed COVID-19. Stockholm: ECDC, 2020."},{"key":"2025082803415687000_14.3.e240891.5","doi-asserted-by":"crossref","first-page":"P28","DOI":"10.1186\/cc9448","article-title":"Usefulness of chest ultrasonography in the management of acute respiratory failure in the emergency room","volume":"15","author":"Silva","year":"2011","journal-title":"Critical Care"},{"key":"2025082803415687000_14.3.e240891.6","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/01.JAA.0000541492.33526.a9","article-title":"Using point-of-care ultrasound: lungs","volume":"31","author":"Breunig","year":"2018","journal-title":"JAAPA"},{"key":"2025082803415687000_14.3.e240891.7","doi-asserted-by":"crossref","first-page":"507","DOI":"10.21037\/atm.2019.07.76","article-title":"The role of point-of-care ultrasound in pediatric acute respiratory distress syndrome: emerging evidence for its use","volume":"7","author":"Potter","year":"2019","journal-title":"Ann Transl Med"},{"key":"2025082803415687000_14.3.e240891.8","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2251011102"},{"key":"2025082803415687000_14.3.e240891.9","doi-asserted-by":"publisher","DOI":"10.1186\/cc5004"},{"key":"2025082803415687000_14.3.e240891.10","doi-asserted-by":"crossref","first-page":"34","DOI":"10.21037\/jeccm.2017.10.09","article-title":"The role of bedside point-of-care ultrasound evaluation of the lung in the critically ill patient","volume":"1","author":"Biswas","year":"2017","journal-title":"J Emerg Crit Care Med"},{"key":"2025082803415687000_14.3.e240891.11","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1111\/anae.15082","article-title":"Point-of-care lung ultrasound in patients with COVID-19 - a narrative review","volume":"75","author":"Smith","year":"2020","journal-title":"Anaesthesia"},{"key":"2025082803415687000_14.3.e240891.12","unstructured":"FUSIC_Accreditation [Internet]. Ics.ac.uk, 2020. Available: https:\/\/www.ics.ac.uk\/ICS\/FUSIC\/FUSIC_Accreditation\/ICS\/FUSIC\/FUSIC_Accreditation.aspx?hkey=03ef026c-cd0c-4bba-9555-8c85bb220b01 [Accessed 26 Oct 2020]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240891","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:42:05Z","timestamp":1756377725000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240891"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,16]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-240891"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240891","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}