Lung Ultrasound – Case 7 – Lung US in the Cachectic Patient- Kylie Baker
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[az_accordion_section] [accordion title=”History” id=”acc-1″] Cachectic, elderly COPD patient.
Review the CXR and lung ultrasound images to develop your diagnosis.[/accordion][accordion title=”CXR” id=”acc-2″] [az_lightbox_image_sh image_url=”https://intensivecarenetwork.com/wp-content/uploads/2014/09/LungUSCase7-CXR.png” thumb_width=”300″ title=”LungUS Case 7 – CXR” gallery_name=”” class=””][/accordion][accordion title=”Ultrasound” id=”acc-4″]
[/accordion] [accordion title=”Answer” id=”acc-5″]The lung US images show the very prominent reverberation artifact (‘A lines’ in the old terms), such that the first reverberation is actually brighter than the true pleura. It is very hard to see sliding because hyper-expanded lung and bullae barely move. When scanning you are reduced to searching for lung pulse or B lines to exclude pneumothorax. Narrow pleural adhesions can mimic B lines, but they are tethered, hence no slide.[/accordion] [accordion title=”Further Resources” id=”acc-6″]
ICN – Lung Ultrasound Guides
Article – Lung Ultrasound in the Critically Ill
Article – The BLUE Team Protocol