Among the several signs of pneumothorax on lung ultrasound (LUS), a definite one is the presence of the lung point, which is observed as the contact between the sliding and non-sliding lung (Video 1). There is also an unusual sign of pneumothorax, which is called the “hydro-point”, as depicted in a 70-year-old male patient with COVID-19 pneumonia. Here, the air in the pleura (pneumothorax, arrows) contacts intermittently with the pleural fluid (pleural effusion, asterisks) within the respiratory cycles (Fig. 1a; L: lung consolidation and Video 2). Chest X-ray showed a similar picture (Fig. 1b). The hydro-point defines the presence of hydropneumothorax and is best assessed with a convex or phased-array probe in basal lateral or posterolateral views of the thorax. Intensivists should be aware of this sign to aid in diagnosis of pneumothorax in the presence of pleural effusion.
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