Lung ultrasound in the intensive care unit: an idea that may be too good to be true

Katz, Judith; Bezreh, James S; Yucel, Evin

doi:10.1007/s00134-014-3606-z

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…The unsupported belief that by US artifacts (B lines) any health professional may specifically and easily diagnose many lung disease cannot be further disseminated. [2][3][4][5][6][7] Nonetheless, we still find that lung US imaging procedures and US-guided intervention are useful.…”

mentioning

confidence: 99%

Usefulness of lung ultrasound imaging in COVID‐19 pneumonia: The persisting need of safety and evidences

Trovato

Sperandeo

2020

Echocardiography

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mentioning

confidence: 99%

Usefulness of lung ultrasound imaging in COVID‐19 pneumonia: The persisting need of safety and evidences

Trovato

Sperandeo

2020

Echocardiography

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“…Despite it was claimed that TUS is a basic application in intensive care units and that can become a useful daily tool in these subsets, such application is not generally used and, actually and quite unexpectedly, after so many years, is still under assessment and evaluation. Reasonably, as smartly and not only polemically commented by an outstanding radiologist, “lung ultrasound in the intensive care unit is an idea that may be too good to be true”[ 53 ]. Actually, limitations of the procedure should be taken in account even more in subsets which may increase the source of errors and even the accessibility of the structures to ultrasound imaging[ 14 ].…”

Section: Emergency: Opportunities and Reliabilitymentioning

confidence: 99%

Thoracic ultrasound: An adjunctive and valuable imaging tool in emergency, resource-limited settings and for a sustainable monitoring of patients

Trovato¹,

Catalano²,

Trovato³

2016

WJR

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Imaging workup of patients referred for elective assessment of chest disease requires an articulated approach: Imaging is asked for achieving timely diagnosis. The concurrent or subsequent use of thoracic ultrasound (TUS) with conventional (chest X-rays-) and more advanced imaging procedures (computed tomography and magnetic resonance imaging) implies advantages, limitations and actual problems. Indeed, despite TUS may provide useful imaging of pleura, lung and heart disease, emergency scenarios are currently the most warranted field of application of TUS: Pleural effusion, pneumothorax, lung consolidation. This stems from its role in limited resources subsets; actually, ultrasound is an excellent risk reducing tool, which acts by: (1) increasing diagnostic certainty; (2) shortening time to definitive therapy; and (3) decreasing problems from blind procedures that carry an inherent level of complications. In addition, paediatric and newborn disease are particularly suitable for TUS investigation, aimed at the detection of congenital or acquired chest disease avoiding, limiting or postponing radiological exposure. TUS improves the effectiveness of elective medical practice, in resource-limited settings, in small point of care facilities and particularly in poorer countries. Quality and information provided by the procedure are increased avoiding whenever possible artefacts that can prevent or mislead the achievement of the correct diagnosis. Reliable monitoring of patients is possible, taking into consideration that appropriate expertise, knowledge, skills, training, and even adequate equipment’s suitability are not always and everywhere affordable or accessible. TUS is complementary imaging procedure for the radiologist and an excellent basic diagnostic tool suitable to be shared with pneumologists, cardiologists and emergency physicians.

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“…Lastly, in order to assess the quality and validity of point-of-care ultrasonography and to permit its correlation with other imaging methods, it is essential that images be documented, ideally on the same picture archiving and communication system used for other imaging[64]. It should be strongly considered that “it is not time to mandate training in the performance of lung ultrasound without proving that ultrasound can reliably make an accurate diagnosis”[65]; moreover, “formal training incorporating ultrasound in adequate curricula is crucial for physicians, avoiding simplistic numeric rules, since medicine is not arithmetic”[66]. The trends of contemporary practice and research address to precision, but also to sustainability within a framework of predictive, preventive and personalized medicine and an affordable implementation of clinical risk assessment and management planning[67-70].…”

Section: Absence Of Tus Imagingmentioning

confidence: 99%

Thoracic ultrasound: A complementary diagnostic tool in cardiology

Trovato

2016

WJC

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Clinical assessment and workup of patients referred to cardiologists may need an extension to chest disease. This requires more in-depth examination of respiratory co-morbidities due to uncertainty or severity of the clinical presentation. The filter and integration of ecg and echocardiographic information, addressing to the clues of right ventricular impairment, pulmonary embolism and pulmonary hypertension, and other less frequent conditions, such as congenital, inherited and systemic disease, usually allow more timely diagnosis and therapeutic choice. The concurrent use of thoracic ultrasound (TUS) is important, because, despite the evidence of the strict links between cardiac and respiratory medicine, heart and chest US imaging approaches are still separated. Actually, available expertise, knowledge, skills and training and equipment’s suitability are not equally fitting for heart or lung examination and not always already accessible in the same room or facility. Echocardiography is useful for study and monitoring of several respiratory conditions and even detection, so that this is nowadays an established functional complementary tool in pulmonary fibrosis and diffuse interstitial disease diagnosis and monitoring. Extending the approach of the cardiologist to lung and pleura will allow the achievement of information on pleural effusion, even minimal, lung consolidation and pneumothorax. Electrocardiography, pulse oximetry and US equipment are the friendly extension of the physical examination, if their use relies on adequate knowledge and training and on appropriate setting of efficient and working machines. Lacking these premises, overshadowing or misleading artefacts may impair the usefulness of TUS as an imaging procedure.

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Lung ultrasound in the intensive care unit: an idea that may be too good to be true

Cited by 5 publications

References 5 publications

Usefulness of lung ultrasound imaging in COVID‐19 pneumonia: The persisting need of safety and evidences

Usefulness of lung ultrasound imaging in COVID‐19 pneumonia: The persisting need of safety and evidences

Thoracic ultrasound: An adjunctive and valuable imaging tool in emergency, resource-limited settings and for a sustainable monitoring of patients

Thoracic ultrasound: A complementary diagnostic tool in cardiology

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