5. Major Lung Ultrasound Pathology Profiles

Major Lung Ultrasound Pathology Profiles

Now that you have a grasp of the most common pathological lung signs to look for, this section will help you use those findings to characterize more specifically the ultrasound profiles of pneumothorax, pneumonia, cardiogenic pulmonary edema, acute respiratory distress syndrome, and COPD.

You can choose to use an algorithm such as the Blue Protocol (Lichtenstein, et al) but after teaching many learners lung ultrasound we’ve found it much easier for you to recognize the lung ultrasound findings that go along with each disease pattern. We will present all of the major disease findings and give you examples of the corresponding lung ultrasound findings below.

Lung signs/findings specific to each disease will be further explained within their respective section. Keep in mind, these are the potential Lung ultrasound findings you will see at the bedside, however, you must coordinate these profiles clinically with what is going on with the patient.

Pulmonary PathologyLung Ultrasound Findings
Pneumothorax– No lung sliding/barcode sign
– Lung point (hard to find)
– Bilateral A-lines (parietal pleura reflection)
Pneumonia– Consolidation or “hepatization of the lung”
– Supleural Consolidations
– “Shred” sign
– Unilateral B-lines or bilateral B-lines
– Possible small plural effusion
– Reduced lung sliding due to thickened pleura in severe cases
– Dynamic air bronchograms (atelectasis has static bronchograms)
Cardiogenic Pulmonary Edema– Widespread and bilateral B-lines
– Normal lung sliding
– Possible bilateral effusion depending on the severity
Acute Respiratory Distress Syndrome (ARDS)– Bilateral or unilateral B-lines
– Normal lung sliding
COPD or Asthma– Bilateral A-lines
– Reduced lung sliding
Pulmonary Embolism (PE)– Bilateral A-Lines
– Deep Vein Thrombosis in Upper or Lower Extremities
– Right Ventricular Enlargement (massive/submassive PE)

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