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肺部超声在急性呼吸衰竭诊断和管理中的应用。

Lung Ultrasound for the Diagnosis and Management of Acute Respiratory Failure.

机构信息

Division of Pulmonary Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.

Division of Critical Care Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.

出版信息

Lung. 2020 Feb;198(1):1-11. doi: 10.1007/s00408-019-00309-1. Epub 2020 Jan 1.

Abstract

For critically ill patients with acute respiratory failure (ARF), lung ultrasound (LUS) has emerged as an indispensable tool to facilitate diagnosis and rapid therapeutic management. In ARF, there is now evidence to support the use of LUS to diagnose pneumothorax, acute respiratory distress syndrome, cardiogenic pulmonary edema, pneumonia, and acute pulmonary embolism. In addition, the utility of LUS has expanded in recent years to aid in the ongoing management of critically ill patients with ARF, providing guidance in volume status and fluid administration, titration of positive end-expiratory pressure, and ventilator liberation. The aims of this review are to examine the basic foundational concepts regarding the performance and interpretation of LUS, and to appraise the current literature supporting the use of this technique in the diagnosis and continued management of patients with ARF.

摘要

对于急性呼吸衰竭(ARF)的危重症患者,肺部超声(LUS)已成为辅助诊断和快速治疗管理不可或缺的工具。在 ARF 中,现在有证据支持使用 LUS 来诊断气胸、急性呼吸窘迫综合征、心源性肺水肿、肺炎和急性肺栓塞。此外,近年来 LUS 的应用范围不断扩大,有助于对患有 ARF 的危重症患者进行持续管理,在容量状态和液体管理、呼气末正压滴定以及呼吸机撤离方面提供指导。本文旨在检查关于 LUS 性能和解释的基本概念,并评估支持该技术在 ARF 患者诊断和持续管理中应用的现有文献。

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