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Review
. 2024 Feb 12;16(1):7.
doi: 10.1186/s13089-023-00351-4.

Lung ultrasound and supine chest X-ray use in modern adult intensive care: mapping 30 years of advancement (1993-2023)

Luigi Vetrugno  1   2 , Daniele Guerino Biasucci  3 , Cristian Deana  4 , Savino Spadaro  5 , Fiorella Anna Lombardi  6 , Federico Longhini  7 , Luigi Pisani  8   9 , Enrico Boero  10 , Lorenzo Cereser  11 , Gianmaria Cammarota  12 , Salvatore Maurizio Maggiore  2   13
Affiliations
Review

Lung ultrasound and supine chest X-ray use in modern adult intensive care: mapping 30 years of advancement (1993-2023)

Luigi Vetrugno et al. Ultrasound J. .

Abstract

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.

Keywords: Chest X-ray; Cost reduction; Critically ill patient; Intensive care; Ionized radiation; Lung ultrasound.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Lung ultrasound vs Chest X-ray Road map. American College of Radiology (ACR), acute respiratory distress syndrome (ARDS), American College of Chest Physicians (ACCP), intensive care unit (ICU), La Société de Réanimation de Langue Française (SRLF), Bedside Lung Ultrasound in Emergency (BLUE) protocol, point of care lung ultrasound POC-LUS, Extended Focused Assessment with Sonography for Trauma (E-FAST), British Thoracic Society (BTS)
Fig. 2
Fig. 2
LUS is a valid bedside tool that helps clinicians to reach the right diagnosis also taking into consideration medical history and clinical examination
Fig. 3
Fig. 3
Assessing interstitial syndrome with LUS for fluid tolerance and intolerance requires antero-lateral chest zone exploration as the posterior zone suffers from fluid gravity
See this image and copyright information in PMC

References

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