Thoracic ultrasound in adult intensive care

Abstract

Lung ultrasound has become a part of the daily examination in intensive care units, and completes the clinical examination. Its ease of use and availability in critical care medicine now allows rapid diagnosis at the bedside of the patient, who is often difficult to move. The lung ultrasound can be systematic and complete, or focused to answer a specific question. A first part reviews the ultrasound semiology of the healthy lung, pleural effusion and pneumothorax. Thoracocentesis or chest tube insertion can no longer be done without ultrasound, which also makes it possible to look for post-procedure complications and to follow the evolution of pleural pathologies. Then the specific applications of lung ultrasound in intensive care will be described, focusing on its role in detecting parenchymal complications such as ventilator-associated pneumonia, assessing lung aeration loss, and evaluating diaphragm function during mechanical ventilation weaning.