Evidence map›Paper›PMID 31923268›Full record

ArticlePloS one2020

Detection of posttraumatic pneumothorax using electrical impedance tomography-An observer-blinded study in pigs with blunt chest trauma.

Felix Girrbach, Tobias Landeck, Dominic Schneider, Stefan U Reske, Gunther Hempel, Sören Hammermüller, Udo Gottschaldt, Peter Salz, Katharina Noreikat, Sebastian N Stehr and 2 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Felix GirrbachDepartment of Anesthesiology and Intensive Care Medicine, University of Leipzig, Leipzig, Germany.ORCID 0000-0002-8371-6463
Tobias LandeckInnovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany.
Dominic SchneiderInnovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany.
Stefan U ReskeHeinrich Braun Hospital Zwickau, Department of Radiology, Zwickau, Germany.
Gunther HempelDepartment of Anesthesiology and Intensive Care Medicine, University of Leipzig, Leipzig, Germany.ORCID 0000-0002-9705-5184
Sören HammermüllerDepartment of Anesthesiology and Intensive Care Medicine, University of Leipzig, Leipzig, Germany.
Udo GottschaldtHeinrich Braun Hospital Zwickau, Department of Anesthesiology and Intensive Care Medicine, Zwickau, Germany.ORCID 0000-0001-7680-5890
Peter SalzInnovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany.
Katharina NoreikatDepartment of Anesthesiology and Intensive Care Medicine, University of Leipzig, Leipzig, Germany.
Sebastian N StehrDepartment of Anesthesiology and Intensive Care Medicine, University of Leipzig, Leipzig, Germany.
Hermann WriggeDepartment of Anesthesiology, Intensive Care and Emergency Medicine, Pain Therapy; Bergmannstrost Hospital Halle, Halle, Germany.
Andreas W ReskeDepartment of Anesthesiology and Intensive Care Medicine, University of Leipzig, Leipzig, Germany.
Leipzig University · DEBG Klinikum Bergmannstrost Halle · DEWestsächsische Hochschule Zwickau · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPosttraumatic pneumothorax (PTX) is often overseen in anteroposterior chest X-ray. Chest sonography and Electrical Impedance Tomography (EIT) can both be used at the bedside and may provide complementary information. We evaluated the performance of EIT for diagnosing posttraumatic PTX in a pig model.

methodsThis study used images from an existing database of images acquired from 17 mechanically ventilated pigs, which had sustained standardized blunt chest trauma and had undergone repeated thoracic CT and EIT. 100 corresponding EIT/CT datasets were randomly chosen from the database and anonymized. Two independent and blinded observers analyzed the EIT data for presence and location of PTX. Analysis of the corresponding CTs by a radiologist served as reference.

results87/100 cases had at least one PTX detected by CT. Fourty-two cases showed a PTX > 20% of the sternovertebral diameter (PTXtrans20), whereas 52/100 PTX showed a PTX>3 cm in the craniocaudal diameter (PTXcc3), with 20 cases showing both a PTXtranscc and a PTXcc3. We found a very low agreement between both EIT observers considering the classification overall PTX/noPTX (κ = 0.09, p = 0.183). For PTXtrans20, sensitivity was 59% for observer 1 and 17% for observer 2, with a specificity of 48% and 50%, respectively. For PTXcc3, observer 1 showed a sensitivity of 60% with a specificity of 51% while the sensitivity of observer 2 was 17%, with a specificity of 89%. By programming a semi-automatized detection algorithm, we significantly improved the detection rate of PTXcc3, with a sensitivity of 73% and a specificity of 70%. However, detection of PTXtranscc was not improved.

conclusionIn our analysis, visual interpretation of EIT without specific image processing or comparison with baseline data did not allow clinically useful diagnosis of posttraumatic PTX. Multimodal imaging approaches, technical improvements and image postprocessing algorithms might improve the performance of EIT for diagnosing PTX in the future.

Indexed as

Electric ImpedanceAlgorithmsAnimalsPneumothoraxRespiration, ArtificialSwineThoracic InjuriesTomography, X-Ray ComputedUltrasonographyWounds, Nonpenetrating

Identifiers

PMID31923268
PMCPMC6953828
OpenAlexW3000352579

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.