Ultrasound: Lungs
Pulmonary edema
- A lines and B lines
- A lines:
- Appear as horizontal lines
- Indicate dry interlobular septa.
- Predominance of A lines has 90% sensitivity, 67% specificity for pulmonary artery wedge pressure <= 13mm Hg
- A line predominance suggests that intravenous fluids may be safely given without concern for pulmonary edema
- B lines ("comets"):
- White lines from the pleura to the bottom of the screen
- Highly sensitive for pulmonary edema, but can be present at low wedge pressures
- A lines:
BLUE (Bedside Lung Ultrasound in Emergency) Protocol[1]
- Predominant A lines + lung sliding = Asthma/COPD
- Multiple predominant B lines anteriorly with lung sliding = Pulmonary Edema
- Normal anterior profile + DVT = PE
- Anterior absent lung sliding + A lines + lung point = Pneumothorax (PTX)
- Anterior alveolar consolidations, anterior diffuse B lines with abolished lung sliding, anterior asymmetric interstitial patterns, posterior consolidations or effusions w/o anterior diffuse B lines = Pneumonia (PNA)
See Also
- ↑ http://ccm.anest.ufl.edu/files/2012/08/BLUELung.pdf Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure - The BLUE Protocol