Chest
Original ResearchCritical Care MedicineRelevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure*: The BLUE Protocol
Section snippets
Materials and Methods
This was an observational study conducted in university-affiliated hospitals over 4 years investigating 301 consecutive adult patients with acute respiratory failure. The official diagnosis was established in the hospitalization report using standardized tests by the ICU staff and not including lung ultrasound data (Table 1). Sixteen patients never received a definite diagnosis, 16 patients had several official diagnoses, and 9 patients had rare (ie, frequency < 2%) diagnoses. To simplify this
Results
This study included 260 patients with a definite diagnosis: 140 men and 120 women (mean age, 68 years; range, 22 to 91 years; SD, 16 years).
Discussion
Briefly, the B profile (anterior interstitial syndrome with lung sliding) indicated pulmonary edema. The B' profile (lung sliding abolished) indicated pneumonia. The A/B profile (asymmetric anterior interstitial syndrome) and the C profile (anterior consolidation) indicated pneumonia, as did the A profile plus PLAPS. The A profile plus venous thrombosis indicated pulmonary embolism. A normal profile indicated COPD/asthma.
These results correspond to physiopathologic patterns, particularly echoed
Conclusions
Lung ultrasound immediately provided diagnosis of acute respiratory failure in 90.5% of cases. It can therefore be added to the armamentarium of critical care.47 The additional value of saving time should provide prompter relief for these severely dyspneic patients.
Acknowledgment
So many people surrounded and helped this project, directly or not, that only a collective but warm thanks will be made in this space. Special thanks to François Jardin, who made this work possible.
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Cited by (0)
This work was presented partly at the twenty-third ISICEM, Brussels, March 30, 2003.
The authors have no conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).