Assessment of Lung Aeration and Recruitment by CT Scan and Ultrasound in Acute Respiratory Distress Syndrome Patients*

Chiumello, Davide; Mongodi, Silvia; Algieri, Ilaria; Vergani, G.; Orlando, Anita; Via, Gabriele; Crimella, Francesco; Cressoni, Massimo; Mojoli, Francesco

doi:10.1097/ccm.0000000000003340

Cited by 213 publications

(199 citation statements)

References 29 publications

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“…However, the protocol did not include the posterior chest, and only the anterior and lateral chest walls were considered. In the 12 regions protocol, anterior, lateral, and posterior areas were included, but in each region, only the intercostal space with the worst ultrasound pattern was calculated . In neonates, linear transducers have been commonly used, and the posterior area is mostly considered .…”

Section: Discussionmentioning

confidence: 99%

“…In the 12 regions protocol, anterior, lateral, and posterior areas were included, but in each region, only the intercostal space with the worst ultrasound pattern was calculated. 11,15,34 In neonates, linear transducers have been commonly used, and the posterior area is mostly considered. 4,5 For this reason, the protocol used in this experiment also included the posterior chest.…”

Section: Evlw Measurements Determined By Transpulmonary Thermodilutionmentioning

confidence: 99%

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Using lung ultrasound to quantitatively evaluate pulmonary water content

Zong

Guo

Liu

et al. 2020

Pediatric Pulmonology

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Background Increases in extravascular lung water (EVLW) can lead to respiratory failure. This study aimed to investigate whether the B‐line score (BLS) was correlated with the EVLW content determined by the lung wet/dry ratio in a rabbit model. Methods A total of 45 New Zealand rabbits were randomly assigned to nine groups. Among the animals, models of various lung water content levels were induced by the infusion of different volumes of warm sterile normal saline (NS) via the endotracheal tube. The arterial blood gas, spontaneous respiratory rate, and PaO2/FiO2 ratio were detected before and after infusion. In addition, the B‐lines were determined before and immediately after infusion in each group. Finally, both lungs were resected to determine the wet/dry ratio. In addition, all lung specimens were analyzed histologically, and EVLW was quantified using the BLS based on the number and confluence of B‐lines in the intercostal space. Results The BLS increased with increasing infusion volume. The BLS was statistically correlated with the wet/dry ratio (r2= .946) and with the PaO2/FiO2 ratio (r2= .916). Furthermore, a repeatability study was performed for the lung ultrasound (LUS) technology (Bland‐Altman plots), and the results suggest that LUS had favorable intraobserver and interobserver reproducibility. Conclusions This study is the first to suggest that the BLS can serve as a sensitive, quantitative, noninvasive, and real‐time indicator of EVLW in a rabbit model of lung water accumulation. Notably, the BLS displayed an obvious correlation with the experimental gravimetry results and could also be used to predict the pulmonary oxygenation status.

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Section: Discussionmentioning

confidence: 99%

Section: Evlw Measurements Determined By Transpulmonary Thermodilutionmentioning

confidence: 99%

Using lung ultrasound to quantitatively evaluate pulmonary water content

Zong

Guo

Liu

et al. 2020

Pediatric Pulmonology

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“…The capacity of LUS to evaluate lung reaeration was also confirmed by Chinardet et al who used it to estimate lung reaeration following pleural drainage in ARDS patients [7]. However, a recent randomized crossover study by Chiumello et al found that variations in the LUS score did not correlate with PEEP-induced lung recruitment due to a still inaccurate definition of consolidation pattern [8]. These results could open up a new line of research aimed at increasing the specificity of ultrasound evaluation.…”

Section: Lung Ultrasound Score (Lus)mentioning

confidence: 88%

Mechanical ventilation weaning issues can be counted on the fingers of just one hand: part 2

et al. 2020

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Assessing heart and diaphragm function constitutes only one of the steps to consider along the weaning path. In this second part of the review, we will deal with the more systematic evaluation of the pulmonary parenchyma-often implicated in the genesis of respiratory failure. We will also consider the other possible causes of weaning failure that lie beyond the cardio-pulmonary-diaphragmatic system. Finally, we will take a moment to consider the remaining unsolved problems arising from mechanical ventilation and describe the so-called protective approach to parenchyma and diaphragm ventilation.

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“…Lung ultrasound may also help in limiting traditional imaging, avoiding patients' transportation to radiology department. It also allows a daily monitoring of clinical evolution, response to treatment and possible complications (pneumothorax, over-infections) [10][11][12].…”

Section: Prefer Lung Ultrasound To Other Imaging Techniquesmentioning

confidence: 99%