{
  "abstract": "Introduction Pre-procedural thoracic ultrasound is a mainstay of pleural intervention, with evidence that its use reduces complication risk. However, there are currently two forms of standard clinical practice for ultrasound use during thoracocenteses and chest drain insertions. In the first, ‘real-time’ ultrasound guidance is used to visualise the inserted needles and tube throughout the procedure, and anaesthetic is administered with the needle tip seen adjacent to the parietal pleura. In the second, the operator inserts needles and the tube not under ‘real-time’ ultrasound guidance, and anaesthetic is injected at a depth approximating that of the external pleural lining. To date, there has been limited comparison of the two techniques, however there is some evidence that real-time ultrasound guidance improves success rates and reduces the likelihood of complications. 1 The current use of real-time ultrasound guidance for pleural procedures in the United Kingdom (UK) is unclear.Methods An electronic survey (Jisc Online Surveys) was circulated via the UK Pleural Society and British Society of Thoracic Imaging newsletters, and through direct communication with centres undertaking pleural procedures.Results 70 responses were received, predominantly from Respiratory Consultants (33%), Radiologists (30%) and Respiratory Registrars (29%). 50% of respondents ‘Never’ or ‘Rarely’ use real-time ultrasound guidance in pleural procedures, while 37% use it ‘Always’ or ‘Often’. Frequently highlighted reasons for not using real-time ultrasound guidance in pleural procedures included a lack of training, technical issues, increased procedure length and insufficient evidence that the technique improves outcomes. The majority of respondents (74%) indicated that they would use real-time ultrasound guidance more for thoracocentesis and chest drain insertions if the technique was shown to significantly reduce pain experienced by patients.Abstract P77 Figure 1Discussion There is significant variability in the use of real-time ultrasound guidance in pleural procedures across the UK. Most respondents indicated that they would increase use of the technique if it were shown to improve outcomes for patients. Randomised studies to assess outcomes of procedures performed under real-time ultrasound guidance are essential.Reference Helgeson SA, Fritz AV, Tatari MM, Daniels CE, Diaz-Gomez JL. Reducing iatrogenic pneumothoraces: using real-time ultrasound guidance for pleural procedures. Crit Care Med. 2019;47(7):903–909.",
  "authors": [
    {
      "affiliations": [
        "Oxford University Hospitals, Oxford, UK"
      ],
      "name": "CA Mounsey"
    },
    {
      "affiliations": [
        "Oxford University Hospitals, Oxford, UK"
      ],
      "name": "B Iqbal"
    },
    {
      "affiliations": [
        "Oxford University Hospitals, Oxford, UK"
      ],
      "name": "DN Addala"
    },
    {
      "affiliations": [
        "Chinese Academy of Medical Sciences Oxford Institute, Oxford, UK"
      ],
      "name": "NI Kanellakis"
    },
    {
      "affiliations": [
        "Oxford University Hospitals, Oxford, UK",
        "Chinese Academy of Medical Sciences Oxford Institute, Oxford, UK"
      ],
      "name": "NM Rahman"
    }
  ],
  "title": "P77 A national survey of real-time ultrasound guidance use in pleural procedures in the United Kingdom",
  "uid": "5276c1e8-d1c0-57e5-a867-38a2e496a8be"
}