Lung water assessment by lung ultrasonography in intensive care: a pilot study

Baldi, Giacomo Giulio; Gargani, Luna; Abramo, Antonio Carlos; D’Errico, Luigia; Caramella, Davide; Picaño, Eugenio; Giunta, Francesco; Forfori, Francesco

doi:10.1007/s00134-012-2694-x

Cited by 127 publications

(87 citation statements)

References 42 publications

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“…The lung ultrasound score is significantly correlated to extravascular lung water measured by gravimetry, 33 the indicator dilution method, 23 or computed tomography. 26 In patients with ARDS and/or pneumonia, consolidated lung areas predominating in dependent lung regions coexist with interstitial and alveolar edema present in anterior and lateral lung regions. Therefore a lung ultrasound score aimed at assessing lung recruitment and derecruitment should include dependent lung regions, which are frequently consolidated.…”

Section: Methods Based On Transthoracic Lung Ultrasoundmentioning

confidence: 99%

“…22 By adding changes in ultrasound pattern detected in each region of interest, ultrasound scores or re-aeration have been proposed and correlated to reference methods for quantifying lung aeration changes (computed tomography, extravascular lung water, pulmonary wedge pressure, PV curves, lung lavage for alveolar proteinosis). 4,[22][23][24][25][26][27] Bedside transthoracic lung ultrasound has been demonstrated to be accurate for assessing re-aeration following fluid depletion in patients with hemodynamic pulmonary edema, PEEP-induced alveolar recruitment in ARDS, 4 lung re-aeration resulting from efficient antimicrobial therapy in patients with community-acquired 28 or ventilator-associated pneumonia, 22 and derecruitment observed at the early phase of acute lung injury 29 or during a spontaneous breathing trial. 30 Two different lung ultrasound scores have been proposed to assess lung recruitment and derecruitment induced by various treatments and lung diseases.…”

Section: Methods Based On Transthoracic Lung Ultrasoundmentioning

confidence: 99%

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Measurement of Alveolar Recruitment at the Bedside: The Beginning of a New Era in Respiratory Monitoring?

et al. 2013

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Section: Methods Based On Transthoracic Lung Ultrasoundmentioning

confidence: 99%

Section: Methods Based On Transthoracic Lung Ultrasoundmentioning

confidence: 99%

Measurement of Alveolar Recruitment at the Bedside: The Beginning of a New Era in Respiratory Monitoring?

et al. 2013

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“…There is a linear relationship between the total number of B-lines and lung weight estimated using CT [83]. One study used whole lung lavage to correlate sonographic imaging to lung water [84].…”

Section: The Interstitial Syndromementioning

confidence: 99%

The efficacy of bedside chest ultrasound: from accuracy to outcomes

Hew

Tay

2016

Eur Respir Rev

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For many respiratory physicians, point-of-care chest ultrasound is now an integral part of clinical practice. The diagnostic accuracy of ultrasound to detect abnormalities of the pleura, the lung parenchyma and the thoracic musculoskeletal system is well described. However, the efficacy of a test extends beyond just diagnostic accuracy. The true value of a test depends on the degree to which diagnostic accuracy efficacy influences decision-making efficacy, and the subsequent extent to which this impacts health outcome efficacy. We therefore reviewed the demonstrable levels of test efficacy for bedside ultrasound of the pleura, lung parenchyma and thoracic musculoskeletal system.For bedside ultrasound of the pleura, there is evidence supporting diagnostic accuracy efficacy, decisionmaking efficacy and health outcome efficacy, predominantly in guiding pleural interventions. For the lung parenchyma, chest ultrasound has an impact on diagnostic accuracy and decision-making for patients presenting with acute respiratory failure or breathlessness, but there are no data as yet on actual health outcomes. For ultrasound of the thoracic musculoskeletal system, there is robust evidence only for diagnostic accuracy efficacy.We therefore outline avenues to further validate bedside chest ultrasound beyond diagnostic accuracy, with an emphasis on confirming enhanced health outcomes. @ERSpublicationsThe next challenge in bedside chest ultrasound is to refocus from diagnostic accuracy toward patient outcomes http://ow.ly/NyNR3027WLU

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“…Активно идет накопление опыта использования трансторакальной сонографии при диагностике до-статочно широкого спектра патологии, относимой к компетенции интернистов, хирургов [10] и педи-атров [5,19]. Причем особое внимание уделяется исследованию возможностей использования со-нографии в отделениях реанимации и отделениях новорожденных, то есть там, где диагностика не-обходима прямо у постели больного, однако до сих пор эти исследования остаются на уровне пилотных проектов [18,23,24].…”

Section: сос тояние проб лемыunclassified

Interstitial Syndrome And Alveolar Consolidation: Sonographic Markers of Hemodynamic Pulmonary Edema In Infants

et al. 2017

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With the purpose of evaluating the possibility of describing hemodynamic pulmonary edema in infants with congenital heart disease using the previously suggested sonographic phenomena “alveolar consolidation” and “interstitial syndrome” in adults, 131 children of both genders were examined at the age of 1-246 days. Of these infants, 47 had congenital heart anomalies, 51 had chronic somatic pathology and patent foramen ovale, and 33 had a somatic pathology associated with either congenital heart disease or small heart abnormalities. The duration of observation and the number of sessions of ultrasound scanning were determined by the health status dynamics of the infants. All infants were described in terms of 179 characteristics of physical examination and laboratory and instrumental findings obtained through standard procedures. Echocardiography and ultrasound lung scans were performed with LOGIQ E (General Electric) and HD11 (Philips) using linear, convex, and sector transducers (7-12, 3-5, and 1.7-4.0 МHz respectively). In addition to standard protocols of heart and lung description, we also registered the square of consolidated parcels summarized for all lung segments, the number of B-lines summarized for all lung segments, and the swing of diaphragm and lung movement and calculated the diaphragm and lung swing ratio. An attempt to describe the differences between pulmonary circulation in terms of ultrasound sonography for heart defects associated and not associated with blood filling in the lungs was successful. The total area of air-free/consolidated subpleural parcels of lungs and the extent of interstitial lung syndrome were the most informative sonographic characteristics. It was concluded that interstitial edema and alveolar consolidation, described in terms of transthoracic ultrasound sonography, are recommended for use as markers of the disorders of pulmonary circulation associated with congenital heart malformations in infants.

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Lung water assessment by lung ultrasonography in intensive care: a pilot study

Abstract: Lung ultrasound B-lines are correlated with lung weight and density determined by CT. LUS may provide a reliable, simple and radiation-free lung densitometry in the intensive care setting.

Cited by 127 publications

References 42 publications

Measurement of Alveolar Recruitment at the Bedside: The Beginning of a New Era in Respiratory Monitoring?

Measurement of Alveolar Recruitment at the Bedside: The Beginning of a New Era in Respiratory Monitoring?

The efficacy of bedside chest ultrasound: from accuracy to outcomes

Interstitial Syndrome And Alveolar Consolidation: Sonographic Markers of Hemodynamic Pulmonary Edema In Infants

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