CHEST Guidelines-Quantitative-Lung-Ultrasound

Quantitative-Lung-Ultrasound_chest

Pdf Summary

In recent years, lung ultrasound has evolved significantly, becoming a vital imaging tool for assessing lung conditions across various settings, including emergency departments (EDs), intensive care units (ICUs), and even in chronic disease management. Initially seen as impractical due to the high air/tissue ratio of the lungs, lung ultrasound became more systematically studied in the 1990s. The technique gained traction with its ability to toggle between artifacts representing normal and pathological aeration and direct imaging of conditions such as consolidations and pleural effusions.<br /><br />Lung ultrasound has moved from a qualitative to a quantitative approach, with numerous scoring systems developed to evaluate lung aeration, relying on the presence of A-lines and B-lines. Specifically, the lung ultrasound score has become prevalent, describing four states of lung aeration: normal, moderate, severe, and complete loss. This system aids in various clinical decisions, including the management of ventilated patients and surfactant replacement in neonates.<br /><br />While offering high interobserver agreement, the technique demands adequate training. Proposals for computer-aided algorithms have emerged to simplify and enhance the accuracy of evaluations. Despite these advancements, variations in scoring systems and techniques may confuse practitioners, indicating a need for consensus on the preferred approaches, scoring systems, and requisite training for different clinical settings. A unified consensus would facilitate more universally accurate application and foster the widespread utility of lung ultrasounds as a monitoring tool across medical disciplines.<br /><br />A consensus could enhance lung ultrasound's efficacy, ensuring its proper implementation and promoting its potential as both a diagnostic and monitoring tool in diverse clinical settings.

Keywords

lung ultrasound

imaging tool

emergency departments

intensive care units

chronic disease management

lung aeration

scoring systems

clinical decisions

computer-aided algorithms

training consensus