Application of Lung Ultrasound in Critical Care Setting: A Review

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.

[1]  C. Vaillancourt,et al.  Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. , 2012, Chest.

[2]  Allison Sauler,et al.  M-Mode Ultrasound Applications for the Emergency Medicine Physician. , 2015, The Journal of emergency medicine.

[3]  A. Varriale,et al.  Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases. , 2008, Journal of ultrasound.

[4]  A. Duggal,et al.  Revisiting Ultrasound-Guided Subclavian/Axillary Vein Cannulations: Importance of Pleural Avoidance With Rib Trajectory , 2017, Journal of intensive care medicine.

[5]  D. Lichtenstein,et al.  The dynamic air bronchogram. A lung ultrasound sign of alveolar consolidation ruling out atelectasis. , 2009, Chest.

[6]  Daniel Lichtenstein,et al.  Comparative Diagnostic Performances of Auscultation, Chest Radiography, and Lung Ultrasonography in Acute Respiratory Distress Syndrome , 2004, Anesthesiology.

[7]  P. Mayo,et al.  Ultrasound in the diagnosis and management of pleural effusions. , 2015, Journal of hospital medicine.

[8]  P. Yang,et al.  Lung abscesses: US examination and US-guided transthoracic aspiration. , 1991, Radiology.

[9]  A. Mittal,et al.  Intraoperative lung ultrasound: A clinicodynamic perspective , 2016, Journal of anaesthesiology, clinical pharmacology.

[10]  E. Gartman,et al.  Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation , 2013, Thorax.

[11]  A. Varriale,et al.  Contrast-enhanced ultrasound (CEUS) for the study of peripheral lung lesions: a preliminary study. , 2006, Ultrasound in medicine & biology.

[12]  F. Gleeson,et al.  COPD can mimic the appearance of pneumothorax on thoracic ultrasound. , 2006, Chest.

[13]  Y Menu,et al.  A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. , 1995, Chest.

[14]  F. Mccool,et al.  Ultrasound evaluation of the paralyzed diaphragm. , 1997, American journal of respiratory and critical care medicine.

[15]  J. Williamson,et al.  Thoracic Ultrasound: What Non-radiologists Need to Know , 2017, Current Pulmonology Reports.

[16]  S. Koenig,et al.  The effect of point-of-care ultrasonography on imaging studies in the medical ICU: a comparative study. , 2014, Chest.

[17]  A. Kirkpatrick,et al.  The sonographic diagnosis of pneumothorax , 2011, Journal of emergencies, trauma, and shock.

[18]  D. Lichtenstein.  Lung ultrasound in acute respiratory failure an introduction to the BLUE-protocol. , 2009, Minerva anestesiologica.

[19]  J. Grymiński,et al.  The diagnosis of pleural effusion by ultrasonic and radiologic techniques. , 1976, Chest.

[20]  L. Papazian,et al.  Usefulness of ultrasonography in predicting pleural effusions > 500 mL in patients receiving mechanical ventilation. , 2005, Chest.

[21]  T. Morgenthaler,et al.  Reducing iatrogenic risk in thoracentesis: establishing best practice via experiential training in a zero-risk environment. , 2009, Chest.

[22]  F. Herth,et al.  Ultrasound vs. CT in detecting chest wall invasion by tumor: a prospective study. , 2008, Chest.

[23]  Dzelaludin Junuzovic,et al.  Application of Ultrasound in Medicine , 2011, Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH.

[24]  Accuracy of lung ultrasound for the diagnosis of consolidations when compared to chest computed tomography , 2015, The American journal of emergency medicine.

[25]  A. Hasan,et al.  B-lines: Transthoracic chest ultrasound signs useful in assessment of interstitial lung diseases , 2014, Annals of thoracic medicine.

[26]  Pan‐Chyr Yang,et al.  Clinical Applications of Transthoracic Ultrasound in Chest Medicine , 2008 .

[27]  P. Yang.  Ultrasound‐Guided Transthoracic Biopsy of Peripheral Lung, Pleural, and Chest‐Wall Lesions , 1997, Journal of thoracic imaging.

[28]  M. Malbrain,et al.  Ten good reasons to practice ultrasound in critical care. , 2014, Anaesthesiology intensive therapy.

[29]  Stefano Di Bartolomeo,et al.  Evaluation of lung ultrasound for the diagnosis of pneumonia in the ED. , 2009, The American journal of emergency medicine.

[30]  A. Moghekar,et al.  Utilization of Thoracic Ultrasound for Confirmation of Central Venous Catheter Placement and Exclusion of Pneumothorax: A Novel Technique in Real-Time Application , 2019, Journal of intensive care medicine.

[31]  G. Tusman,et al.  Ultrasonography for the assessment of lung recruitment maneuvers , 2016, Critical Ultrasound Journal.

[32]  D. Lichtenstein,et al.  The comet-tail artifact: an ultrasound sign ruling out pneumothorax , 1999, Intensive Care Medicine.

[33]  Mao Zhang,et al.  Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. , 2011, Chest.

[34]  Chin-Pyng Wu,et al.  Echogenic swirling pattern as a predictor of malignant pleural effusions in patients with malignancies. , 2004, Chest.

[35]  F. Mccool,et al.  Monitoring recovery from diaphragm paralysis with ultrasound. , 2008, Chest.

[36]  T. Higami,et al.  Examination of Intercostal Arteries with Transthoracic Doppler Sonography , 2010, Echocardiography.

[37]  R. Davies,et al.  Diagnostic accuracy, safety and utilisation of respiratory physician-delivered thoracic ultrasound , 2010, Thorax.

[38]  M. Blaivas,et al.  A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. , 2005, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[39]  P. Mircea,et al.  Intrathoracic tumors in contact with the chest wall--ultrasonographic and computed tomography comparative evaluation. , 2012, Medical ultrasonography.

[40]  D. Greenbaum,et al.  The value of routine daily chest x‐rays in intubated patients in the medical intensive care unit , 1982, Critical care medicine.

[41]  D. Chiumello.  Bedside ultrasound assessment of positive end expiratory pressure-induced lung recruitment. , 2012, American journal of respiratory and critical care medicine.

[42]  W. Self,et al.  High discordance of chest x-ray and computed tomography for detection of pulmonary opacities in ED patients: implications for diagnosing pneumonia. , 2013, The American journal of emergency medicine.

[43]  J. Stowell,et al.  Ultrasound-Guided Cannulation: Time to Bring Subclavian Central Lines Back , 2016, The western journal of emergency medicine.

[44]  D. Gad,et al.  Percutaneous transthoracic needle aspiration, lavage and instillation of clindamycin–gentamycin in peripheral pyogenic lung abscess , 2014 .

[45]  N. Sverzellati,et al.  Semi-quantification of pneumothorax volume by lung ultrasound , 2014, Intensive Care Medicine.

[46]  F. Gleeson,et al.  Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010 , 2010, Thorax.

[47]  D. Feller-Kopman,et al.  American College of Chest Physicians/La Société de Réanimation de Langue Française statement on competence in critical care ultrasonography. , 2009, Chest.