“Ultrasound Comet-Tail Images”: A Marker Of Pulmonary Edema

Agricola, Eustachio; Bove, Tiziana; Oppizzi, Michele; Marino, Giovanni; Zangrillo, Alberto; Margonato, Alberto; Picaño, Eugenio

doi:10.1378/chest.127.5.1690

Cited by 535 publications

(170 citation statements)

References 19 publications

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“…The first international trial evaluating these modalities was performed by Agricola et al 28 They enrolled 20 post-cardiac surgery patients and compared a 'comet score' (cumulative) with wedge pressure, chest radiography and PiCCO 2 ®. They found a statistically significant positive linear correlation (r = 0.42; p = 0.01) between the comet score and the ELWI generated by transpulmonary thermodilution.…”

Section: Discussionmentioning

confidence: 99%

Comparison of lung ultrasound with transpulmonary thermodilution in assessing extra-vascular lung water

Turton

Raubenheimer

2016

Southern African Journal of Anaesthesia and Analgesia

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Background: Increased extra-vascular lung water (EVLW) is common in critical care and correlates with the severity of acute lung injury, length of intensive care unit stay and mortality. Lung ultrasound (LUS) can assess EVLW by determining the amount of 'B-lines': artefacts signifying alveolar-interstitial oedema. This study's aim was to determine whether EVLW estimation with the help of LUS correlates with the more accurate PiCCO 2 ® cardiac output system utilising transpulmonary thermodilution. Methods: This prospective observational study was undertaken at Universitas Academic Hospital, Bloemfontein. Patients were scanned according to a fixed protocol, followed by transpulmonary thermodilution. The cumulative B-line count was compared with the EVLW index generated by the PiCCO 2 ® system. Results: Four males and six females were enrolled. The mean EVLW index was 9.1 ml/kg/m 2 (standard deviation 1.45), and the median cumulative B-line count was 14 (interquartile range 6-25). A positive, but not statistically significant, correlation was found (r = 0.40, p = 0.25) between the B-line count and EVLW index. Conclusion: This study investigated a possible correlation between LUS interpretation and transpulmonary thermodilution in assessing EVLW. Results seem promising, but the small sample could indicate only that LUS might be of use for the assessment of EVLW. Further studies are needed.

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Section: Discussionmentioning

confidence: 99%

Comparison of lung ultrasound with transpulmonary thermodilution in assessing extra-vascular lung water

Turton

Raubenheimer

2016

Southern African Journal of Anaesthesia and Analgesia

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“…В первую фазу нарушение нормального соотно-шения воздуха и жидкости визуализируется в виде артефакта (реверберации), представляющего со-бой линейные гиперэхогенные сигналы, поддаю-щиеся счету и называемые кометами [3,4,6,9,14,15,17] или В-линиями [13,21]. Появление таких линий принято считать свидетельством так называ-емого интерстициального синдрома [12,16,22,23].…”

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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“…Most of the diagnostic procedures of TUS concern the anterior wall, as well as lateral parts of the chest cage. The anterior wall is delimitated from the sternum to the anterior axillary row, the lateral wall is delimitated from the anterior to the posterior axillary row, and the posterior wall is delimitated from the paravertebral row, the scapular row, and the posterior axillary row [11,[22][23][24] . Thoracic parts are obviously the same in both areas, but the presence of the heart on the left side reduces helpful scansion in that area.…”

Section: Scanning Proceduresmentioning

confidence: 99%

Incremental value of thoracic ultrasound in intensive care units: Indications, uses, and applications

Liccardo

Martone

Trambaiolo

et al. 2016

WJR

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Emergency physicians are required to care for unstable patients with life-threatening conditions, and thus must make decisions that are both quick and precise about unclear clinical situations. There is increasing consensus in favor of using ultrasound as a real-time bedside clinical tool for clinicians in emergency settings alongside the irreplaceable use of historical and physical examinations. B-mode sonography is an old technology that was first proposed for medical applications more than 50 years ago. Its application in the diagnosis of thoracic diseases has always been considered limited, due to the presence of air in the lung and the presence of the bones of the thoracic cage, which prevent the progression of the ultrasound beam. However, the close relationship between air and water in the lungs causes a variety of artifacts on ultrasounds. At the bedside, thoracic ultrasound is based primarily on the analysis of these artifacts, with the aim of improving accuracy and safety in the diagnosis and therapy of the various varieties of pulmonary pathologic diseases which are predominantly "water-rich" or "air-rich". The indications, contraindications, advantages, disadvantages, and techniques of thoracic ultrasound and its related procedures are analyzed in the present review. Core tip: The close relationship between air and water in the lungs causes a variety of artifacts on ultrasounds. At the bedside, thoracic ultrasound is based primarily on the analysis of these artifacts, with the aim of improving accuracy and safety in the diagnosis and therapy of Liccardo B et al . Thoracic ultrasound in ICU the various varieties of pulmonary pathologic diseases which are predominantly "water-rich" or "air-rich". The indications, contraindications, advantages, disadvantages, and techniques of thoracic ultrasound and its related procedures are analyzed in the present review.

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“Ultrasound Comet-Tail Images”: A Marker Of Pulmonary Edema

Cited by 535 publications

References 19 publications

Comparison of lung ultrasound with transpulmonary thermodilution in assessing extra-vascular lung water

Comparison of lung ultrasound with transpulmonary thermodilution in assessing extra-vascular lung water

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

Incremental value of thoracic ultrasound in intensive care units: Indications, uses, and applications

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