Prediction model of rhomboid major and pleura depth based on
anthropometric features to decrease the risk of pneumothorax during dry
needling
Abstract
Background: Although mostly common adverse events associated to dry
needling can be considered minor, serious adverse events including
induced pneumothorax cannot be excluded, and safety instructions for
reducing the risk of pleura puncture are needed. Objective: To
investigate if anthropometric features can predict the rhomboid major
muscle and pleura depth in a sample of healthy subjects to avoid the
risk of pneumothorax during dry needling. Methods: A diagnostic study
was conducted on 59 healthy subjects (52.5 % male) involving a total of
236 measurements (both sides in maximum inspiration and expiration), to
calculate the accuracy of a prediction model for both pleura and
rhomboid depth, as assessed with ultrasound imaging, based on sex, age,
height, weight, body mass index (BMI), breathing and chest
circumference. A correlation matrix and a multiple linear regression
analyses were used to detect those variables contributing significantly
to the variance in both locations. Results: Men showed greater height,
weight, BMI, thorax circumference and skin-to-rhomboid,
rhomboid-to-pleura y skin-to-pleura distances (p<0.001). Sex,
BMI, and thorax circumference explained 51.5% of the variance of the
rhomboid (p<0.001) and 69.7% of pleura (p<0.001)
depth limit. In general, inserting a maximum length of 19 mm is
recommended to reach the deep limit of rhomboid major decreasing the
risk of passing through the pleura. Conclusion: This study identified
that gender, BMI and thorax circumference can predict both rhomboid and
pleura depth, as assessed with ultrasonography, in healthy subjects. Our
findings could assist clinicians in the needle length election for
avoiding the risk of induced pneumothorax during dry needling.