Description of Bullous Emphysema Using Lung Ultrasound and Comparison to the Characteristics of Pneumothorax

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    University Hospital, Rouen
Updated on 7 May 2021
ct scan
chest x-ray
pulmonary function test
pulmonary disease


Chronic Obstructive Pulmonary Disease (COPD) is a frequent disease affecting a growing number of adults in the world which is responsible for a large public health burden through heavy morbidity and mortality.

Emphysema is one of a wide spectrum of pulmonary complications linked to COPD, defined as the abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of the alveolar wall. Disease progression is correlated to worsening and enlargement of emphysema lesions, sometimes conflating in sizeable bullae, deleterious to normal mechanical pulmonary function. Bullous emphysema (BE) is sometimes eligible to invasive curative treatment through surgery or interventional bronchoscopy.

Diagnosis of BE relies on computerized tomodensitometry (CT), the gold-standard for evaluating pulmonary parenchyma. However, CT is not always available, and bullous emphysema can present as pneumothorax on chest radiography.

The practice of lung ultrasound is currently growing in respiratory medicine and emergency departments owing to an increasing amount of evidence showcasing its reliability as a diagnostic tool, most notably for pneumothorax and other pleural diseases. Despite BE having been reported to present similarly to pneumothorax in ultrasound, its characteristics have not yet been precisely described.

The primary aim of this study is to describe BE using lung ultrasound. Participants with known BE on CT will undergo a simple ultrasound examination. The secondary aim is to compare the characteristics of BE to those of pneumothorax using lung ultrasound. To achieve this, a second group of participants with currently treated pneumothorax will also undergo lung ultrasound.

Condition Chronic Obstructive Lung Disease, Emphysema, COPD (Chronic Obstructive Pulmonary Disease), pulmonary emphysema
Treatment Pulmonary function tests, Clinical examination, Lung ultrasound, Chest radiography
Clinical Study IdentifierNCT04012359
SponsorUniversity Hospital, Rouen
Last Modified on7 May 2021


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Inclusion Criteria

Is your age greater than or equal to 18 yrs?
Gender: Male or Female
Do you have Emphysema?
Do you have any of these conditions: Emphysema or Chronic Obstructive Lung Disease or COPD (Chronic Obstructive Pulmonary Disease) or pulmonary emphysema?
Do you have any of these conditions: Chronic Obstructive Lung Disease or Emphysema or COPD (Chronic Obstructive Pulmonary Disease) or pulmonary emphysema?
Do you have any of these conditions: COPD (Chronic Obstructive Pulmonary Disease) or Emphysema or pulmonary emphysema or Chronic Obstructive Lung Disease?
Bullous emphysema group
Consultation or scheduled hospitalization in a Pulmonary Medicine department
Past medical history of emphysema on computerized tomodensitometry dating less than two years
Bullous emphysema with subpleural contact of two or more intercostal spaces on tomodensitometry
Pneumothorax group
Hospitalized in a Pulmonary Medicine department for the treatment of a pneumothorax
Patent pneumothorax visible on chest x-ray dating less than 24 hours

Exclusion Criteria

Bullous emphysema group
Current pneumothorax
Past medical history of pleurodesis or pleural thickening homolateral to the bullous emphysema
All patients
Organ failure (hemodynamic, neurological, respiratory)
Recent thoracic surgery dating less than 7 days with subcutaneous emphysema
Minor participant or otherwise deprived of their freedom or their ability to consent freely
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