{"id":29207,"date":"2025-10-31T04:07:00","date_gmt":"2025-10-30T20:07:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29207"},"modified":"2025-10-31T05:51:36","modified_gmt":"2025-10-30T21:51:36","slug":"intensive-care-medicine%e5%bd%b1%e5%83%8f%ef%bc%9a%e6%b0%b4%e4%b8%ad%e7%9a%84%e6%b0%94%e4%bd%93%ef%bc%9a%e6%b6%b2%e7%82%b9%e5%be%81","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29207","title":{"rendered":"[Intensive Care Medicine\u5f71\u50cf]\uff1a\u6c34\u4e2d\u7684\u6c14\u4f53\uff1a\u6db2\u70b9\u5f81"},"content":{"rendered":"\n<p>Imaging in Intensive Care Medicine<\/p>\n\n\n\n<h1 class=\"wp-block-heading\">\"Air in the water\"\u2014the hydropoint sign<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Eleni Soilemezi,\u00a0Petros Morfesis,\u00a0Vassiliki Birmpa, et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Intensive Care Med 2025; 51: 1721\u20131723<\/h3>\n\n\n\n<p>A 30-year-old female patient was admitted in ICU due to community-acquired pneumonia causing bilateral lung infiltrations and severe hypoxemia requiring mechanical ventilation. An episode of rapid desaturation (SpO<sub>2<\/sub>\u00a087% despite increased FiO<sub>2<\/sub>\u00a0to 100%) triggered a new lung ultrasound assessment, which revealed the presence of hydropneumothorax, i.e., both air and fluid were present in the pleural cavity. The typical ultrasonographic finding in hydropneumothorax is called hydropoint and does not share the same features with lung point, the finding establishing the diagnosis of pneumothorax. Instead, the hydropoint sign describes the dynamic change between a pneumothorax pattern and a pattern of pleural effusion during respiration, corresponding to the interface between air and fluid in the pleural cavity. Therefore, a repetitive change from parietal pleural with A-lines only (and no signs of lung tissue such as sliding, B-lines, or lung pulse), to pleural effusion (Fig.\u00a0<a href=\"https:\/\/link.springer.com\/article\/10.1007\/s00134-025-07943-9#Fig1\">1<\/a>a, b, ESM video), was demonstrated. Insertion of a chest drain restored the patient\u2019s oxygen saturation.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/media.springernature.com\/full\/springer-static\/image\/art%3A10.1007%2Fs00134-025-07943-9\/MediaObjects\/134_2025_7943_Fig1_HTML.png?as=webp\" alt=\"\" width=\"840\" height=\"645\"\/><\/figure>\n\n\n\n<p><strong>A<\/strong>\u00a0Demonstration of parietal pleura and pleural effusion at end-expiration.\u00a0<strong>B<\/strong>\u00a0Without moving the transducer, A-lines appear at endinspiration at the exact site where pleural fluid was previously seen. It should be noted that A-lines are not accompanied by other signs of lung tissue, such as B-line(s) or lung sliding. The alternating pattern from pleural effusion to parietal pleura with A-lines during different phases of the respiratory cycle, constitutes the hydropoint sign, which denotes the presence of hydropneumothorax.\u00a0<strong>C<\/strong>\u00a0The scanning site where the hydropoint sign was identified, located posteriorly to the midaxillary line.\u00a0<strong>D<\/strong>\u00a0The chest X-ray performed immediately after the ultrasound finding of hydropneumothorax.\u00a0<strong>E<\/strong>,\u00a0<strong>F<\/strong>\u00a0A small lung point is identified only at the apex of the lung immediately after insertion of a midaxillary chest drain, corresponding to a remaining small apical pneumothorax. The lung point clearly separates the presence of a small remaining pneumothorax (demonstrated as visible parietal pleura with reverberating A-lines only), from lung tissue (visceral pleura with B-lines)<\/p>\n\n\n\n<p>Conclusively, the hydropoint (Fig.\u00a0<a href=\"https:\/\/link.springer.com\/article\/10.1007\/s00134-025-07943-9#Fig2\">2<\/a>) sign is an ultrasonographic sign of dynamic nature, distinctly different from lung point. The specific clinical setting, where the sign is recognized, determines its significance and urgency to treat.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/media.springernature.com\/full\/springer-static\/image\/art%3A10.1007%2Fs00134-025-07943-9\/MediaObjects\/134_2025_7943_Fig2_HTML.png?as=webp\" alt=\"\"\/><\/figure>\n\n\n\n<p>Hydropneumothorax and hydropoint \u2013 Tips for intensivists<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Imaging in Intensive Care Medicine &#8220;Air in the water&#8221;\u2014t [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[16,13],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29207"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29207"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29207\/revisions"}],"predecessor-version":[{"id":29208,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29207\/revisions\/29208"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}