5. Major Lung Ultrasound Pathology Profiles

Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is often fatal and the risk of death increases with age and severity of the illness. ARDS is characterized by the rapid onset of widespread inflammation in the lungs. The most common cause of ARDS is sepsis, but can also be precipitated by inhalation of harmful substances, pancreatitis, aspiration, severe pneumonia, or near-drowning experiences. Notice how nearly all of these etiologies involve a form of fluid buildup or inflammation so ARDS will present with B-lines on thoracic ultrasound.

People with ARDS also have severe shortness of breath, rapid breathing, and may often need support from a ventilator.

Since the following ultrasound profile is similar to the profile of cardiogenic pulmonary edema, practitioners must use other clinical features to interpret these findings to rule out elevated left heart pressure as the cause of the B-lines.

ARDS Ultrasound Profile

  • Bilateral or unilateral B-lines
  • Lung sliding present (but may be diminished due to inflammation
  • On echocardiography, the patient should have normal diastolic function.

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