Arbelot Charlotte, Ferrari Fabio, Bouhemad Belaïd, Rouby Jean-Jacques
Surgical Intensive Care Unit, Department of Anesthesiology and Critical Care, Assistance Publique Hôpitaux de Paris, University of Paris-6 Pierre et Marie Curie, Paris, France.
Curr Opin Crit Care. 2008 Feb;14(1):70-4. doi: 10.1097/MCC.0b013e3282f43d05.
Lung ultrasound at the bedside can provide accurate information on lung status in critically ill patients with acute respiratory distress syndrome.
Lung ultrasound can replace bedside chest radiography and lung computed tomography for assessment of pleural effusion, pneumothorax, alveolar-interstitial syndrome, lung consolidation, pulmonary abscess and lung recruitment/de-recruitment. It can also accurately determine the type of lung morphology at the bedside (focal or diffuse aeration loss), and therefore it is useful for optimizing positive end-expiratory pressure. The learning curve is brief, so most intensive care physicians will be able to use it after a few weeks of training.
Lung ultrasound is noninvasive, easily repeatable and allows assessment of changes in lung aeration induced by the various therapies. It is among the most promising bedside techniques for monitoring patients with acute respiratory distress syndrome.
床旁肺部超声可为急性呼吸窘迫综合征危重症患者的肺部状况提供准确信息。
肺部超声可替代床旁胸部X线摄影及肺部计算机断层扫描,用于评估胸腔积液、气胸、肺泡-间质综合征、肺实变、肺脓肿及肺复张/萎陷情况。它还能在床旁准确判定肺部形态类型(局灶性或弥漫性通气丧失),因此有助于优化呼气末正压。其学习曲线较短,多数重症监护医师经几周培训后即可使用。
肺部超声无创、易于重复,可评估各种治疗引起的肺通气变化。它是监测急性呼吸窘迫综合征患者最具前景的床旁技术之一。