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Anaesthesiology
Lung Ultrasound
Built from Practical Ultrasound in Anesthesia
What’s inside
8 sections · 64 slides
Overview
- Lung ultrasound at a glance
How the beam meets the lung
Why air stops ultrasound, and the three artifacts that replace anatomy.
- Air stops the ultrasound beam
- A-lines: normal or extra air
- B-lines: less air, more fluid
- Consolidation: no air left
- How aeration loss changes the image
- The main limitation
Chest areas and probe position
The acoustic windows into the lung, and the two probe views.
- Why scan many points
- The three chest areas
- Longitudinal and oblique views
Parenchymal conditions
Interstitial syndromes and consolidation, and how to tell their causes apart.
- The interstitial syndrome
- B-lines rule out more than they rule in
- Making the pattern specific
- Interstitial syndrome: reading the table
- Pulmonary Conditions that are Associated with Interstitial Syndrome
- The consolidation pattern
- Diseases behind consolidation
- Telling consolidations apart
- Sonographic Characteristics of Different Acute Pulmonary Conditions Indicated by a Consolidation Pattern on Lung Ultrasound
- Tailor the exam to the question
- COVID-19 changed scanning practice
- Which areas for which setting
- Main Techniques (Chest Areas) for the Early Diagnostic Lung Ultrasound Approach to Some Parenchymal Pulmonary Conditions in Different Settings
Pleural conditions
Pneumothorax and pleural effusion: the signs that confirm or exclude them.
- Lung sliding
- Absent sliding is not enough
- The lung point
- Pneumothorax: the diagnostic sequence
- Defining pleural effusion
- The sinusoid sign
- Exudate or transudate
- Air rises, fluid sinks
- Ruling out pneumothorax fast
- Finding an effusion
Acute clinical scenarios
Respiratory failure, shock, trauma, and cardiac arrest.
- The BLUE protocol
- BLUE's limits
- Multiorgan ultrasound
- Lung ultrasound in shock
- Three trauma targets in order
- Pneumothorax and hemothorax first
- Contusions as an early warning
- Cardiac arrest
- Peri-arrest uses
Quantifying and monitoring
Scores for aeration, congestion, pneumothorax, and effusion.
- Scoring aeration
- Tracking aeration change
- COVID-19 needs a simpler score
- Congestion scoring
- Aeration versus congestion scoring
- B-lines track lung water
- Using B-lines to guide fluids
- Sizing a pneumothorax
- Monitoring a pneumothorax
- Estimating effusion volume
Anesthesia and comparison with X-ray
Lung ultrasound in anesthesia, and how it measures against chest radiography.
- Lung ultrasound in anesthesia
- Versus chest X-ray
- Where ultrasound wins
- COVID-19 made the case
- References
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- Practical Ultrasound in Anesthesia for Critical Care and Pain Management