Purpose: In the pediatric population, iatrogenic pneumothorax is diagnosed with a frequency of 0.3 to 0.48 per 1,000 patients. The importance of transthoracic lung ultrasonography (TLU) in the diagnosis of pneumothorax has significantly increased in the recent years and there are no published prospective studies on the possibility of the use of transthoracic lung ultrasound (TLU) in the diagnosis of iatrogenic pneumothorax in children. These data were the basis to prospective studies for the possibility of using TLU in the diagnosis pneumothorax in children.
Aim of study: The aim of the study was to investigate the role of TLU in the diagnosis of iatrogenic pneumothorax in children with neoplastic disease of the hematopoietic system.
Methods: We prospectively studied a group of patients who underwent implantations central venous access to the subclavian vessels. We analyzed 115 lung ultrasound examinations performed in 63 children, 25 girls (39.7%) and 38 boys (60.3%), aged from 1 to 17 years old with neoplastic disease of the hematopoietic system. Sonographic criteria for the diagnosis of pneumothorax was adopted in accordance with the criteria used in adult patients.
Results: In the analyzed group of patients with known or suspected malignancy, iatrogenic pneumothorax was diagnosed in 4 of 63 patients (6.3%). In all cases, this was a consequence of the procedures associated with the implantation of a central catheter. The sensitivity, specificity and predictive values (positive and negative) for TLU were 100%, while for bedside chest radiography 25%, 100%, 100% and 92.5 % respectively.
Conclusions: TLU is a very effective method in the diagnosis of iatrogenic pneumothorax in children. However, in order to confirm this thesis multicenter studies are needed on a much larger group of children.
