Principles of Lung Ultrasound

LUNG ULTRASOUND

2015

5-10 MHz

1-5 MHz

INTENSIVE CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

Kocijancic et al ., J Clin Ultrasound 31: 69-74, 2003

COOPERATIVE PATIENTS

CRITICALLY ILL PATIENTS

Via et al ., Int Care Med «26: 999-1007, 2010

CHEST/LUNG ULTRASOUND

ARTIFACT

1. Pleural sliding2. “A” lines3. “B” lines4. “Z” lines5. Lung Consolidation6. Pleural effusions7. Pneumothorax

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

ARTIFACTS

NORMAL / EXPECTED PATTERNS1. Lung sliding2. “A” lines3. “Z” lines4. SEASHORE SIGN

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

ARTIFACT

LUNG CONSOLIDATION PATTERN

CT SCAN CORRELATION

CLINICAL CASE

55, femaleCurrent smoker 35years.packCrack addictedFever, cough, chest painLeuco 18.500 bast 6%

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

ARTIFACT

PLEURAL EFFUSION PATTERN1. “WAVING HAND”

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

ARTIFACT

LUNG CONSOLIDATION PATTERN

WITH AIR BRONCHOGRAM

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

ARTIFACT

DIAPHRAGMATIC PATTERN1. TORACO-ABDOMINAL TRANSITION

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

ARTIFACT

INTERSTITIAL PATTERN1. “B” lines: regular and/or irregular2. Pleural sliding and gross tidal volume

(Vt)

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND

ARTIFACT

PNEUMOTHORAX PATTERN1. LUNG SLIDING: presence or absence2. EXCLUSIVE “A” lines3. “BARCODE SIGN”

4. IF presence of “B” lines: NO PNEUMOTHORAX

CRITICAL CARE ULTRASOUNDCHEST/LUNG ULTRASOUND