Pleural Sliding During Valsalva and Muller Maneuvers

NCT02386696 | Completed

• 1 other identifier: 1436/15
• Study Type: interventional
• Target: 20
• Locations: 0 countries
• Sites: N/A

Brief Summary

Recently, ultrasound artifacts mimicking lung sliding have been described in absence of the visceral pleura, in a group of patients who underwent pneumonectomy. In these patients, lung sliding was clearly absent during mechanical ventilation in the operated hemithorax. During spontaneous breathing, although of lower intensity compared to the unoperated hemithorax, some artifacts mimicking lung sliding and seashore sign were found during each deep spontaneous breath. These findings have led to the hypothesis that these artifacts may be due to the contraction of the intercostal muscles. The objective of the present study is to reproduce such artifacts during contraction of the inspiratory and expiratory muscles with closed glottis (Valsalva and Muller maneuvers): in this condition each subject is not ventilating and the two pleural layers are not sliding one over each other.

Conditions

Pleural and Lung Ultrasound

Outcome Measures

Primary Outcomes (1)

• lung ultrasound artifacts during contraction of the inspiratory and expiratory muscles with closed glottis (Valsalva and Muller maneuvers).

  16 days

Study Arms (1)

Ultrasound findings

EXPERIMENTAL

Thoracic ultrasound examinations in the following conditions: 1. Apnea; 2. Spontaneous regular breathing; 3. Valsalva maneuver, during which each subject will be asked for performing three forced expirations with closed glottis after one forced inspiration; 4. Muller maneuver, during which each subject will be asked for performing three forced inspirations after one forced expiration; 5. Hyperventilation.

Other: Ultrasound

Interventions

Ultrasound OTHER

Lung ultrasound examination on healthy volunteers

Ultrasound findings

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Twenty healthy male volunteers aged between 18 and 65 years-old with no history of respiratory or cardiovascular pathologies will be enrolled.

You may not qualify if:

• Females and all subjects with history of respiratory or cardiovascular diseases will be excluded.

Sponsors & Collaborators

• Catholic University of the Sacred Heart: lead
• Daniele Guerino Biasucci, M.D.: collaborator

Related Publications (11)

• Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, Melniker L, Gargani L, Noble VE, Via G, Dean A, Tsung JW, Soldati G, Copetti R, Bouhemad B, Reissig A, Agricola E, Rouby JJ, Arbelot C, Liteplo A, Sargsyan A, Silva F, Hoppmann R, Breitkreutz R, Seibel A, Neri L, Storti E, Petrovic T; International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012 Apr;38(4):577-91. doi: 10.1007/s00134-012-2513-4. Epub 2012 Mar 6.

  PMID: 22392031 BACKGROUND

• Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest. 1995 Nov;108(5):1345-8. doi: 10.1378/chest.108.5.1345.

  PMID: 7587439 BACKGROUND

• Lichtenstein DA. Ultrasound in the management of thoracic disease. Crit Care Med. 2007 May;35(5 Suppl):S250-61. doi: 10.1097/01.CCM.0000260674.60761.85.

  PMID: 17446785 BACKGROUND

• Koenig SJ, Narasimhan M, Mayo PH. Thoracic ultrasonography for the pulmonary specialist. Chest. 2011 Nov;140(5):1332-1341. doi: 10.1378/chest.11-0348.

  PMID: 22045878 BACKGROUND

• Turner JP, Dankoff J. Thoracic ultrasound. Emerg Med Clin North Am. 2012 May;30(2):451-73, ix. doi: 10.1016/j.emc.2011.12.003.

  PMID: 22487114 BACKGROUND

• Lichtenstein DA, Meziere G, Lascols N, Biderman P, Courret JP, Gepner A, Goldstein I, Tenoudji-Cohen M. Ultrasound diagnosis of occult pneumothorax. Crit Care Med. 2005 Jun;33(6):1231-8. doi: 10.1097/01.ccm.0000164542.86954.b4.

  PMID: 15942336 BACKGROUND

• Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. Chest. 2012 Mar;141(3):703-708. doi: 10.1378/chest.11-0131. Epub 2011 Aug 25.

  PMID: 21868468 BACKGROUND

• Blaivas M, Lyon M, Duggal S. A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med. 2005 Sep;12(9):844-9. doi: 10.1197/j.aem.2005.05.005.

  PMID: 16141018 BACKGROUND

• Weaver B, Lyon M, Blaivas M. Confirmation of endotracheal tube placement after intubation using the ultrasound sliding lung sign. Acad Emerg Med. 2006 Mar;13(3):239-44. doi: 10.1197/j.aem.2005.08.014. Epub 2006 Feb 22.

  PMID: 16495415 BACKGROUND

• Cavaliere F, Zamparelli R, Soave MP, Gargaruti R, Scapigliati A, De Paulis S. Ultrasound artifacts mimicking pleural sliding after pneumonectomy. J Clin Anesth. 2014 Mar;26(2):131-5. doi: 10.1016/j.jclinane.2013.09.011. Epub 2014 Feb 21.

  PMID: 24561105 BACKGROUND

• Biasucci DG, Cina A, Sandroni C, Moscato U, Dauri M, Vetrugno L, Cavaliere F. Influence of intercostal muscles contraction on sonographic evaluation of lung sliding: a physiological study on healthy subjects. J Anesth Analg Crit Care. 2024 May 6;4(1):31. doi: 10.1186/s44158-024-00168-0.

  PMID: 38711161 DERIVED

MeSH Terms

Interventions

High-Energy Shock Waves

Intervention Hierarchy (Ancestors)

Ultrasonic Waves; Sound; Radiation, Nonionizing; Radiation; Physical Phenomena

Study Officials

• Franco Cavaliere, M.D., Prof.

  Institute of Anesthesia and Intensive Care Medicine, Catholic University of the Sacred Heart in Rome, Italy

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Franco Cavaliere, M.D., Prof.

Study Record Dates

• First Submitted: March 7, 2015
• First Posted: March 12, 2015
• Study Start: January 1, 2015
• Primary Completion: February 1, 2015
• Study Completion: February 1, 2015
• Last Updated: March 24, 2015

Record last verified: 2015-03