The Use of Lung Ultrasound in a Surgical Intensive Care Unit

• Published in: Acute and critical care Vol. 32; no. 4; pp. 323 - 332
• Main Authors: Kang, Hyung Koo, So, Hyo Jin, Kim, Deok Hee, Koo, Hyeon-Kyoung, Park, Hye Kyeong, Lee, Sung-Soon, Jung, Hoon
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Critical Care Medicine 01.11.2017; 대한중환자의학회
• Subjects: complication; lung; Original; surgical intensive care; ultrasonography; 마취과학; lung; surgical intensive care; complication; ultrasonography
• ISSN: 2383-4870; 2586-6052; 2383-4889; 2586-6060
• DOI: 10.4266/kjccm.2017.00318

Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.