Polish recommendations for lung ultrasound in internal medicine (POLLUS-IM)

Abstract

Objective The aim of this study was to establish recommendations for the use of lung ultrasound in internal medicine, based on reliable data and expert opinions. Methods The bibliography from the databases (Pubmed, Medline, OVID, Embase) has been fully reviewed up to August 2017. Members of the expert group assessed the credibility of the literature data. Then, in three rounds, a discussion was held on individual recommendations (in accordance with the Delphi procedure) followed by secret voting. Results Thirty-eight recommendations for the use of lung ultrasound in internal medicine were established as well as discussed and subjected to secret voting in three rounds. The first 31 recommendations concerned the use of ultrasound in the diagnosis of the following conditions: pneumothorax, pulmonary consolidation, pneumonia, atelectasis, pulmonary embolism, malignant neoplastic lesions, interstitial lung lesions, cardiogenic pulmonary edema, interstitial lung diseases with fibrosis, dyspnea, pleural pain and acute cough. Furthermore, seven additional statements were made regarding the technical conditions of lung ultrasound examination and the need for training in the basics of lung ultrasound in a group of doctors during their specialization programs and medical students. The panel of experts established a consensus on all 38 recommendations.

Lung and Intercostal Upper Abdomen Ultrasonography for Staging Patients with Ovarian Cancer: A Method Description and Feasibility Study

“…Ultrasonography of the pleurae and lungs, including the diaphragm, has been extensively described [12,13]. Detection and estimation of the pleural effusion volume using ultrasonography is reproducible and independent of the operator [12].…”

“…After excluding patients with FIGO disease stages I and IIA (n = 6) and those who underwent diagnostic laparoscopy because of poor performance status or comorbidities (n = 6), complete (R0) and optimal (R < 1 cm) cytoreduction was achieved in 40 (61%) and 7 (11%) patients, respectively. Median time from the ultrasound examination to surgery was 5 days (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. All patients expressed their willingness to undergo the additional lung and intercostal upper abdomen ultrasound examination, and there were no technical problems associated with this procedure.…”

“…Recently, it was shown that a detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to CT for assessing pelvic/abdominal tumor spread disease in women with EOC [11]. Lung ultrasonography is a recognized imaging modality that can be successfully used in many conditions including cancer [12,13]. In a general population of patients with pleural effusions, one could suspect malignant effusions based on ultrasonographic findings [14].…”

Use of bedside ultrasound to assess fluid status: a literature review

“…The assessment of le sion distribution, localization of B-line artifacts, regularity of B-line artifact distribution, as well as the pleural line and asso ciated lesions may help determine whether the condition is cardiogenic or lung related. 18,19,49,50 It should be noted that in the population of hemodialyzed patients with HF, the assessment may be limited. 51 The development of guidelines and an algorithm for the assessment of body fluid status with lung ultrasound that would allow physicians to refer the examination to the general population would be an important step.…”

Ab0601 utilization of a Multispecialty Team for the Diagnosis of Giant Cell Arteritis Reduces Patient Morbidity

“…In about 10% of cases, the lung is the only organ affected and in as many as 30% of patients without clinical symptoms of lower respiratory tract involvement, abnormalities in chest imaging examinations can be found (2). The efficacy of lung ultrasound (LUS) is very well documented in many pulmonary diseases (3,4). Single publications indicate its applicability also in diagnostics of complications secondary to systemic connective tissue disease, e.g., lung fibrosis or diffuse alveolar hemorrhage (5,6).…”