Lung ultrasound and supine chest X-ray use in modern adult intensive care: mapping 30 years of advancement (1993–2023)

• Published in: The ultrasound journal Vol. 16; no. 1; pp. 7 - 12
• Main Authors: Vetrugno, Luigi, Biasucci, Daniele Guerino, Deana, Cristian, Spadaro, Savino, Lombardi, Fiorella Anna, Longhini, Federico, Pisani, Luigi, Boero, Enrico, Cereser, Lorenzo, Cammarota, Gianmaria, Maggiore, Salvatore Maurizio
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 12-02-2024; Springer Nature B.V; SpringerOpen
• Subjects: Chest; Chest X-ray; Computed tomography; Cost reduction; Critical Care Medicine; Critically ill patient; Diagnostic Radiology; Electrical impedance; Emergency Medicine; Image acquisition; Imaging; Intensive; Intensive care; Interventional Radiology; Ionized radiation; Lung ultrasound; Lungs; Medical imaging; Medicine; Medicine & Public Health; Parameter modification; Radiology; Review; Thorax; Tomography; Ultrasonic imaging; Ultrasound; Intensive care; Lung ultrasound; Chest X-ray; Critically ill patient; Ionized radiation; Cost reduction
• ISSN: 2524-8987; 2524-8987
• DOI: 10.1186/s13089-023-00351-4

In critically ill patients with acute respiratory failure, thoracic images are essential for evaluating the nature, extent and progression of the disease, and for clinical management decisions. For this purpose, computed tomography (CT) is the gold standard. However, transporting patients to the radiology suite and exposure to ionized radiation limit its use. Furthermore, a CT scan is a static diagnostic exam for the thorax, not allowing, for example, appreciation of "lung sliding". Its use is also unsuitable when it is necessary to adapt or decide to modify mechanical ventilation parameters at the bedside in real-time. Therefore, chest X-ray and lung ultrasound are today's contenders for shared second place on the podium to acquire a thoracic image, with their specific strengths and limitations. Finally, electrical impedance tomography (EIT) could soon have a role, however, its assessment is outside the scope of this review. Thus, we aim to carry out the following points: (1) analyze the advancement in knowledge of lung ultrasound use and the related main protocols adopted in intensive care units (ICUs) over the latest 30 years, reporting the principal publications along the way, (2) discuss how and when lung ultrasound should be used in a modern ICU and (3) illustrate the possible future development of LUS.