Using sonography to assess lung recruitment in patients with acute respiratory distress syndrome

Gardelli, Greta; Feletti, Francesco; Gamberini, Emiliano; Bonarelli, S.; Nanni, Andrea; Mughetti, Maurizio

doi:10.1007/s10140-008-0734-1

Cited by 30 publications

(23 citation statements)

References 5 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Soummer

Parratte

Brisson

et al. 2012

Critical Care Medicine

406

362

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Section: Discussionmentioning

confidence: 99%

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

Soummer

Parratte

Brisson

et al. 2012

Critical Care Medicine

406

362

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“…In a recent interesting case study by Gardelli et al . [22], the use of transthoracic US in identifying recruitable lung density areas was reported. These authors managed to show the recruitment of consolidated areas with lower PEEP in a female patient with ARDS in the prone position.…”

Section: Discussionmentioning

confidence: 99%

Lung sonography and recruitment in patients with early acute respiratory distress syndrome: A pilot study

et al. 2011

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IntroductionBedside lung sonography is a useful imaging tool to assess lung aeration in critically ill patients. The purpose of this study was to evaluate the role of lung sonography in estimating the nonaerated area changes in the dependent lung regions during a positive end-expiratory pressure (PEEP) trial of patients with early acute respiratory distress syndrome (ARDS).MethodsTen patients (mean ± standard deviation (SD): age 64 ± 7 years, Acute Physiology and Chronic Health Evaluation II (APACHE II) score 21 ± 4) with early ARDS on mechanical ventilation were included in the study. Transthoracic sonography was performed in all patients to depict the nonaerated area in the dependent lung regions at different PEEP settings of 5, 10 and 15 cm H2O. Lung sonographic assessment of the nonaerated lung area and arterial blood gas analysis were performed simultaneously at the end of each period. A control group of five early ARDS patients matched for APACHE II score was also included in the study.ResultsThe nonaerated areas in the dependent lung regions were significantly reduced during PEEP increases from 5 to 10 to 15 cm H2O (27 ± 31 cm2 to 20 ± 24 cm2 to 11 ± 12 cm2, respectively; P < 0.01). These changes were associated with a significant increase in arterial oxygen partial pressure (74 ± 15 mmHg to 90 ± 19 mmHg to 102 ± 26 mmHg; P < 0.001, respectively). No significant changes were observed in the nonaerated areas in the dependent lung regions in the control group.ConclusionsIn this study, we show that transthoracic lung sonography can detect the nonaerated lung area changes during a PEEP trial of patients with early ARDS. Thus, transthoracic lung sonography might be considered as a useful clinical tool in the management of ARDS patients.

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“…15 The evaluation of recruitment maneuver efficacy by means of CUS can be carried out at the patient's bedside. The advantages of this approach include the reduction of risks connected to the transportation of a patient, as well as the ability to gradually increase ventilation pressure and reduce the risk of barotrauma without exposing the patient to radiation.…”

Section: Recruitmentmentioning

confidence: 99%

Chest Ultrasonography in the ICU

Gardelli¹,

Feletti

Nanni

et al. 2012

Respir Care

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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.

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Using sonography to assess lung recruitment in patients with acute respiratory distress syndrome

Cited by 30 publications

References 5 publications

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

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

Lung sonography and recruitment in patients with early acute respiratory distress syndrome: A pilot study

Chest Ultrasonography in the ICU

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