Disorders of Immunity and Respiration of the Pediatric Critical Patients Research Group, Institut de Recerca Hospital Sant Joan de Deu, Barcelona, Spain; Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu and University of Barcelona, Barcelona, Spain.
Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu and University of Barcelona, Barcelona, Spain.
Paediatr Respir Rev. 2020 Nov;36:136-141. doi: 10.1016/j.prrv.2019.09.006. Epub 2019 Sep 30.
Lung ultrasound (LUS), a non-invasive non-ionizing radiation tool, has become essential at the bedside in both adults and children, particularly in the critically ill. This manuscript reviews normal LUS patterns and the most important pathologies that LUS allows to diagnose. Normal LUS is represented by the pleural line, the lung-sliding and the A-lines and B-lines. These two last findings are artifacts derived from the pleural line. Pleural effusion appears as an anechoic collection. Pneumothorax is suspected when only A-lines are present, without lung-sliding and B-lines. Alveolo-interstitial syndrome is characterized by different degrees of confluent B-lines and can be present in different pathologies such as pulmonary edema and acute respiratory distress syndrome. The distribution of B-lines helps to differentiate between them. LUS is useful to evaluate the response to lung recruitment in pathologies such as acute respiratory distress syndrome or acute chest syndrome. The distribution of B-lines also appears to be useful to monitor the response to antibiotics in pneumonia. However, further studies are needed to further ascertain this evidence. LUS is also useful to guide thoracocentesis.
肺部超声（LUS）是一种非侵入性、非电离辐射的工具，在成人和儿童中，特别是在危重病患者的床边，已经成为必不可少的工具。本文回顾了正常的 LUS 模式以及 LUS 允许诊断的最重要的病理。正常的 LUS 由胸膜线、肺滑动和 A 线和 B 线表示。这后两种发现是源自胸膜线的伪影。胸腔积液表现为无回声积聚。当仅存在 A 线，而没有肺滑动和 B 线时，怀疑存在气胸。肺泡-间质综合征的特征是不同程度的融合 B 线，并可存在于不同的病理中，如肺水肿和急性呼吸窘迫综合征。B 线的分布有助于区分它们。LUS 可用于评估急性呼吸窘迫综合征或急性胸部综合征等疾病中肺复张的反应。B 线的分布似乎也可用于监测肺炎对抗生素的反应。然而，需要进一步的研究来进一步确定这一证据。LUS 也可用于指导胸腔穿刺术。
