{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:52:01Z","timestamp":1791039121857,"version":"4.1.0"},"reference-count":21,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"unspecified","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2024,12,5]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Bedside thoracic ultrasound (US) offers numerous advantages over chest X-ray (CXR) for identification of recurrent pneumothoraces (PTX) after tube thoracostomy (TT) removal. Technologic advancements have led to the development of hand-held devices capable of producing high-quality images termed ultra-portable US (UPUS). We hypothesized that UPUS would be as successful as CXR in detecting post-TT removal PTX and would be preferred by patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a single-center prospective, feasibility, study at a level I trauma center investigating the use of UPUS in patients with trauma with TT placement. UPUS images were obtained daily while the TT was in place and post-TT removal (ranging from 1 through 6\u2009hours). A clinically concerning PTX on UPUS was defined as the absence of lung sliding on two or more intercostal spaces. Poststudy Likert surveys were administered to assess patient preferences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ninety-two patients were included in the analysis. The majority were men (87%), and the median age was 47 years. Thirty-five patients (36%) had discordant imaging findings. There were 11 clinically concerning PTX, of which 10 (91%) were detected on UPUS and 8 (73%) on CXR. Three patients required an intervention for post-pull PTX, all of whom were identified on UPUS. Eighty-four percent (N=70) of surveyed patients preferred UPUS over CXR with 92% reporting no discomfort with UPUS compared with 49% with CXR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Bedside UPUS is preferred by patients and can successfully identify clinically concerning post-TT removal PTX. Implementation of UPUS as a post-TT removal diagnostic tool is a safe and effective alternative to CXR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of evidence<\/jats:title>\n                  <jats:p>Level II, diagnostic tests or criteria.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2024-001464","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T11:25:12Z","timestamp":1735644312000},"page":"e001464","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility of ultraportable US in detecting clinically concerning recurrent pneumothorax in patients with chest trauma"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6294-9957","authenticated-orcid":false,"given":"Abdul Hafiz","family":"Al Tannir","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Pokrzywa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6086-8966","authenticated-orcid":false,"given":"Patrick B","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7639-1955","authenticated-orcid":false,"given":"Elise A","family":"Biesboer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basil S","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1942-4650","authenticated-orcid":false,"given":"Marc","family":"DeMoya","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Carver","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"2025082410421571000_9.1.e001464.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2007.06.004"},{"key":"2025082410421571000_9.1.e001464.2","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1016\/j.injury.2020.07.055","article-title":"Is a chest radiograph after thoracostomy tube removal necessary? A cost-effective analysis","volume":"51","author":"Beattie","year":"2020","journal-title":"Injury"},{"key":"2025082410421571000_9.1.e001464.3","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.amjsurg.2009.03.011","article-title":"Omission of routine chest x-ray after chest tube removal is safe in selected trauma patients","volume":"199","author":"Goodman","year":"2010","journal-title":"Am J Surg"},{"key":"2025082410421571000_9.1.e001464.4","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/TA.0000000000004324","article-title":"Thoracic cavity irrigation prevents retained hemothorax and decreases surgical intervention in trauma patients","volume":"97","author":"Al Tannir","year":"2024","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082410421571000_9.1.e001464.5","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1097\/XCS.0000000000001125","article-title":"Implementation of 300-mL Rule for Management of Traumatic Hemothorax","volume":"239","author":"Al Tannir","year":"2024","journal-title":"J Am Coll Surg"},{"key":"2025082410421571000_9.1.e001464.6","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.jemermed.2021.07.006","article-title":"Traumatic Pneumothorax: A Review of Current Diagnostic Practices And Evolving Management","volume":"61","author":"Tran","year":"2021","journal-title":"J Emerg Med"},{"key":"2025082410421571000_9.1.e001464.7","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.injury.2022.09.025","article-title":"Ultrasound may safely replace chest radiograph after tube thoracostomy removal in trauma patients","volume":"54","author":"Miles","year":"2023","journal-title":"Injury"},{"key":"2025082410421571000_9.1.e001464.8","doi-asserted-by":"crossref","DOI":"10.1186\/s13089-015-0020-x","article-title":"The risk of cumulative radiation exposure in chest imaging and the advantage of bedside ultrasound","volume":"7","author":"Gargani","year":"2015","journal-title":"Crit Ultrasound J"},{"key":"2025082410421571000_9.1.e001464.9","article-title":"Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax in trauma patients in the emergency department","volume":"7","author":"Chan","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082410421571000_9.1.e001464.10","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s11739-010-0347-z","article-title":"Detection of spontaneous pneumothorax with chest ultrasound in the emergency department","volume":"5","author":"Barillari","year":"2010","journal-title":"Intern Emerg Med"},{"key":"2025082410421571000_9.1.e001464.11","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1111\/ans.16717","article-title":"Recurrent pneumothorax following chest tube removal in thoracic stab wounds: a comparative study between end inspiratory versus end expiratory removal techniques at a major trauma centre in South Africa","volume":"91","author":"Kong","year":"2021","journal-title":"ANZ J Surg"},{"key":"2025082410421571000_9.1.e001464.12","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200104000-00013"},{"key":"2025082410421571000_9.1.e001464.13","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1097\/00005373-200212000-00008","article-title":"When should a chest radiograph be obtained after chest tube removal in mechanically ventilated patients? 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