Veterinary point-of-care ultrasound probe orientation and location for detection of pleural effusion in canine cadavers: a pilot study.

OBJECTIVES

To evaluate whether point-of-care ultrasound probe location (at or below the costochondral junction) and probe orientation (perpendicular or parallel to the ribs) affect operator ability to detect pleural effusion in a canine cadaver model.

MATERIALS AND

METHODS

Twelve intubated canine cadavers with scant to large volume pleural effusion were scanned in sternal recumbency while receiving positive pressure ventilation. Twelve operators (2 emergency and critical care specialists, 2 veterinary students and 8 interns) performed blinded bilateral thoracic point-of-care ultrasound using two randomised scanning protocols: a modified TFAST for pleural fluid technique and a modified Calgary PLUS for pleural fluid technique. Hemithoraces were categorised as scant-to-mild or moderate-to-large effusion for statistical analysis. Paired detection rates were compared using McNemar's test.

RESULTS

Overall detection of pleural effusion was significantly higher using the modified Calgary PLUS for pleural fluid technique compared with the modified TFAST for pleural fluid technique (89.1% vs. 60.9%; P < .001). There was a statistically significant increase in the detection of scant-to-mild effusion with the modified Calgary PLUS for pleural fluid technique (84.4% vs. 37.5%; P < .001). No significant difference was observed for moderate-to-large effusions (93.8% vs. 84.4%; P = .25).

CLINICAL SIGNIFICANCE: The site assessed and probe orientation used with different thoracic point-of-care ultrasound protocols can influence the operator's ability to detect pleural effusion in positive pressure ventilation canine cadavers placed in sternal recumbency. Incorporating a probe orientation that is parallel to the ribs in the more ventral regions of the thorax during point-of-care ultrasound may improve the operator's detection of pleural effusions, particularly when smaller volumes of pleural fluid are present.