Assessment of Stress-induced Pulmonary Interstitial Edema by Chest Ultrasound During Exercise Echocardiography and its Correlation with Left Ventricular Function

Ultrasound assessment of lung aeration loss during a successful weaning trial predicts postextubation distress*

“…Transthoracic lung ultrasound has several advantages over conventional radiological means for assessing lung aeration: it is reliable and accurate (17,18,23), highly reproducible (34), noninvasive, and easily repeatable at the bedside. Several studies have demonstrated that lung ultrasound is accurate for assessing positive end-expiratory pressure and prone position-induced lung recruitment (17,(35)(36)(37), lung reaeration following antimicrobial therapy in ventilator-associated and communityacquired pneumonia (18), and lung reaeration associated with resolution of various forms of pulmonary edema (38)(39)(40)(41)(42)(43)(44). Although the ultrasound detection of SBT-induced lung derecruitment does not give any indication about the cause of aeration loss, upper airway obstruction, persisting pneumonia, congestive heart failure, aspiration of secretions, cough inefficient to remove excessive bronchial secretions, and muscle weakness as observed in critically ill patients with polyneuropathy, it can be used as a predictor of extubation failure.…”

Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets*

“…Of course, these data need to be confirmed in humans with ALI/ARDS. However, chest sonography findings must be considered in the clinical context and information provided by ULCs must be integrated with other investigations, such as hemodynamic studies by echocardiography to assess left ventricular filling pressures, which are increased in the presence of congestive heart failure, another condition associated with ULCs (5,22).…”

Measurement of Alveolar Recruitment at the Bedside: The Beginning of a New Era in Respiratory Monitoring?

“…22 By adding changes in ultrasound pattern detected in each region of interest, ultrasound scores or re-aeration have been proposed and correlated to reference methods for quantifying lung aeration changes (computed tomography, extravascular lung water, pulmonary wedge pressure, PV curves, lung lavage for alveolar proteinosis). 4,[22][23][24][25][26][27] Bedside transthoracic lung ultrasound has been demonstrated to be accurate for assessing re-aeration following fluid depletion in patients with hemodynamic pulmonary edema, PEEP-induced alveolar recruitment in ARDS, 4 lung re-aeration resulting from efficient antimicrobial therapy in patients with community-acquired 28 or ventilator-associated pneumonia, 22 and derecruitment observed at the early phase of acute lung injury 29 or during a spontaneous breathing trial. 30 Two different lung ultrasound scores have been proposed to assess lung recruitment and derecruitment induced by various treatments and lung diseases.…”