This study investigates the tendency of Point-of-Care Ultrasound (POCUS) to overestimate pneumothorax in patients with severe emphysema. Researchers analyzed POCUS images of 48 chronic obstructive pulmonary disease (COPD) patients to examine whether emphysema induces a "barcode pattern" in ultrasound. Results showed that 13.8% of lobes exhibited a barcode pattern, while 20.3% had absent or indeterminate lung sliding. Additionally, 54.7% of lobes displayed an ultrasound pattern that did not fit existing M-mode classifications. The study correlated these abnormal ultrasound findings with high-resolution CT (HRCT) and pulmonary function tests but found no strong associations. AView COPD software from Coreline Soft was used for HRCT analysis, contributing to the evaluation of emphysema severity and its relationship with abnormal ultrasound findings