Chest Ultrasonography in the ICU

Abstract

SummaryChest diagnostic imaging is essential when dealing with a critically ill patient. At present, direct visualization of the lung parenchyma is performed with a chest x-ray and computed tomography with the patient in the supine position. The relative ease of bedside ultrasound examination and the availability of user-friendly, inexpensive, portable equipment have made chest ultrasonography an interesting and alternative method in various situations, because it offers accurate information that is of therapeutic and diagnostic relevance. We describe equipment and examination technique, normal findings, and chest ultrasonography signs detected in some pathological situations, such as pneumothorax, consolidations, pleural effusions, ARDS, and pulmonary edema.

Recruitment Maneuvers and PEEP Titration

“…9). 97 In 40 subjects with ARDS, Bouhemad et 94 al compared P-V curves and ultrasound at PEEP of 0 and 15 cm H 2 O. A significant correlation was found between PEEP-induced lung recruitment assessed by P-V curves and ultrasound reaeration score, suggesting that PEEP-induced lung recruitment can be adequately estimated with bedside ultrasound.…”

Use of Lung Ultrasound in Detection of Complications of Respiratory Distress Syndrome

“…A pleural line is an echogenic line that lies between the two shadows of the ribs and represents the pleural surface (Gardelli et al 2012). Pleural line abnormalities are defined as thickening (.0.5 mm), irregularity or coarsening or the presence of small sub-pleural consolidation patches (Fig.…”

Overview of current lung imaging in acute respiratory distress syndrome

“…Lung ultrasonography can accurately demonstrate an ''interstitial syndrome'' which, in the appropriate clinical context, can be considered as suggestive of pulmonary oedema [38]. According to some authors, ultrasonography criteria to differentiate cardiogenic and permeability oedema could be detected [39].…”