Vetrugno Luigi, Biasucci Daniele Guerino, Deana Cristian, Spadaro Savino, Lombardi Fiorella Anna, Longhini Federico, Pisani Luigi, Boero Enrico, Cereser Lorenzo, Cammarota Gianmaria, Maggiore Salvatore Maurizio
Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.
Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, 66100, Chieti, Via Dei Vestini, Italy.
Ultrasound J. 2024 Feb 12;16(1):7. doi: 10.1186/s13089-023-00351-4.
In critically ill patients with acute respiratory failure, thoracic images are essential for evaluating the nature, extent and progression of the disease, and for clinical management decisions. For this purpose, computed tomography (CT) is the gold standard. However, transporting patients to the radiology suite and exposure to ionized radiation limit its use. Furthermore, a CT scan is a static diagnostic exam for the thorax, not allowing, for example, appreciation of "lung sliding". Its use is also unsuitable when it is necessary to adapt or decide to modify mechanical ventilation parameters at the bedside in real-time. Therefore, chest X-ray and lung ultrasound are today's contenders for shared second place on the podium to acquire a thoracic image, with their specific strengths and limitations. Finally, electrical impedance tomography (EIT) could soon have a role, however, its assessment is outside the scope of this review. Thus, we aim to carry out the following points: (1) analyze the advancement in knowledge of lung ultrasound use and the related main protocols adopted in intensive care units (ICUs) over the latest 30 years, reporting the principal publications along the way, (2) discuss how and when lung ultrasound should be used in a modern ICU and (3) illustrate the possible future development of LUS.
在患有急性呼吸衰竭的重症患者中，胸部影像对于评估疾病的性质、范围和进展以及临床管理决策至关重要。为此，计算机断层扫描（CT）是金标准。然而，将患者转运至放射科以及暴露于电离辐射限制了其应用。此外，CT扫描是一种针对胸部的静态诊断检查，例如无法观察到“肺滑动”。当需要在床边实时调整或决定修改机械通气参数时，其使用也不合适。因此，胸部X线和肺部超声是如今在获取胸部影像方面争夺第二名的竞争者，它们各有优缺点。最后，电阻抗断层成像（EIT）可能很快会发挥作用，不过，其评估不在本综述范围内。因此，我们旨在阐述以下几点：（1）分析过去30年来重症监护病房（ICU）中肺部超声使用的知识进展以及相关主要方案，报告这一过程中的主要出版物；（2）讨论在现代ICU中应如何以及何时使用肺部超声；（3）说明肺部超声检查（LUS）未来可能的发展方向。
