Application of Lung Ultrasound in Critical Care Setting: A Review

Abstract

This article reviews the use of thoracic ultrasound in the intensive care unit (ICU). The focus of this article is to review the basic terminology and clinical applications of thoracic ultrasound. The diagnostic approach to a breathless patient, the blue protocol, is presented in a simplified flow chart. The diagnostic application of thoracic ultrasound in lung parenchymal and pleural diseases, role in bedside procedures, diaphragmatic assessment, and lung recruitment are described. Recent updates discussed in this review help support its increasingly indispensable role in the emergent and critical care setting.

Deep Learning for Classification and Localization of COVID-19 Markers in Point-of-Care Lung Ultrasound

“…Lately, ultrasound imaging, a more widely available, costeffective, safe and real-time imaging technique, is gaining attention. In particular, lung ultrasound (LUS) is increasingly used in point-of-care settings for detection and management of acute respiratory disorders [6], [7]. In some cases, it demonstrated better sensitivity than chest X-ray in detecting pneumonia [8].…”

Point-of-Care Ultrasound: Applications in Low- and Middle-Income Countries

“…Pulmonary and pleural POCUS have proven to play an essential role in the Emergency Rooms and Critical Care Units of high-income countries [ 20 , 21 ]. POCUS does not expose patients to radiation and has also shown to be more sensitive and specific in diagnosing many pulmonary conditions than chest radiography (CXR) [ 22 – 24 ].…”

“…Pathologic interstitial findings such as vertical B-lines or alveolar consolidation (hepatization with air bronchogram), as well as echogenic debris, fluid, or absent sliding between the parietal and visceral pleura, assist diagnosing the above conditions with high accuracy [ 21 , 25 ]. Physiologic signs are horizontal A-lines and lung sliding with a typical M-mode pattern referred to as the seashore sign.…”

“…The extended FAST (eFAST) protocol includes the FAST protocol’s standard views and adds coronal views of the supradiaphragmatic pleural space with the high-depth curvilinear probe and sagittal views of the anterior pleural space with a high-resolution linear probe. The extended protocol can detect a hemothorax, pneumothorax, and pleural effusions with higher sensitivity and specificity than CXR [ 21 , 57 , 58 ].…”

Implementación del ultrasonido pulmonar en la UCI durante la pandemia de COVID-19

“…La introducción del USP ha revolucionado la evaluación y monitoreo de los pacientes en la UCI moderna. [7][8][9] La radiografía es de uso rutinario, pero afortunadamente cada vez menor; en la UCI se le asignan múltiples aplicaciones como la evaluación de la adecuada colocación de dispositivos invasivos (acceso vascular y tubo endotraqueal), así como parte del abordaje diagnóstico en la falla respiratoria; sin embargo, en un estudio deficiente (diferencias interobservador, técnica, poca sensibilidad y especificidad en las diferentes www.medigraphic.org.mx patologías), el USP, sin duda, tomará su lugar como la técnica rutinaria en la UCI. 10 En el 2004, Lichtenstein y colaboradores compararon diferentes métodos diagnósticos como son: la parte clínica (auscultación), radiografía de tórax, y ultrasonido pulmonar.…”