Ultrasound in the ICU · Bedside diagnosis of respiratory failure
Relevance of lung ultrasound in the diagnosis of acute respiratory failure
| Design | Prospective multicentre diagnostic accuracy study |
|---|---|
| Treatment | Lung ultrasound using a defined protocol of scanning points and artefact profiles |
| Control | Final diagnosis established by the ICU team |
| Population | Patients admitted to intensive care with acute respiratory failure |
| Follow-up | Diagnostic study |
| Primary endpoint | Accuracy of ultrasound profiles for the cause of respiratory failure |
| Result | Predominant A lines with lung sliding indicated asthma or COPD with 89% sensitivity and 97% specificity. Multiple anterior diffuse B lines with lung sliding indicated pulmonary oedema, and other profiles distinguished pneumonia, pulmonary embolism and pneumothorax. Overall diagnostic accuracy was 90.5%. |
| Secondary endpoints | Accuracy for individual diagnoses, time to diagnosis |
Lung ultrasound can help the clinician make a rapid diagnosis in patients with acute respiratory failure, thus meeting the priority objective of saving time.
The trial authors, in the published abstract
Turned lung ultrasound from a curiosity into a diagnostic discipline by naming reproducible artefact profiles rather than trying to image anatomy. Single-operator accuracy in expert hands is the standing caveat — the numbers are a ceiling, not an expectation.
Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 2008 Jul;134(1):117-25.