Chest Sonography in CriticallyIll PatientsGamal Rabie Agmy ,MD ,FCCPProfessor of Chest Diseases, Assiut UniversityERS Nati...
cAt the bedside, chest radiography remains the reference for lung imaging incritically ill patients. However, radiographic...
Risk of transportationLung Computed Tomography inthe Critically illhttp://www.reapitie-02 09 2012
Scanning Positions forChest Sonography in ICU
Normal Anatomy
Tissue pattern representative of AlveolarConsolidationPresence of hyperechoic punctiformimagesrepresentative of air bronch...
the "seashore sign" (Fig.3).
Clinical applications of lung ultrasonography in theintensive care unit1. Diagnosis of pulmonary consolidation.2. Diagnosi...
Absent lung slidingExaggerated horizontal artifactsLoss of comet-tail artifactsBroadening of the pleural line to a ban...
the "seashore sign" (Fig.3).
Pulmonary Embolism
Schematic representation of the parenchymal, pleural and vascularfeatures associated with pulmonary embolism.(Angelika Rei...
Alveolar-interstitial syndrome
Multiple B-lines - « comet-tails » - interstitial edema(B1)7 mm apart « B lines » thickened interlobularseptaD Lichtenstei...
D Lichtenstein et al AJRCCM 156 : 1640-1646 , 199730 11 2011Coalescent B lines - « comet-tails » - alveolaredema3 mm apart...
(Chest. 2008; 133:836-837)© 2008 American College of Chest PhysiciansUltrasound: The Pulmonologist’s New BestFriendMomen M...
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
Sudanese chest sonography workshop (Sonography in critical ill patients)
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Sudanese chest sonography workshop (Sonography in critical ill patients)

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Sudanese chest sonography workshop (Sonography in critical ill patients)

  1. 1. Chest Sonography in CriticallyIll PatientsGamal Rabie Agmy ,MD ,FCCPProfessor of Chest Diseases, Assiut UniversityERS National Delegate of Egypt
  2. 2. cAt the bedside, chest radiography remains the reference for lung imaging incritically ill patients. However, radiographical images are often oflimited quality• Movements of the chest wall• Film cassette posterior to thethorax• X-ray beam originating anteriorly, ata shorter distance thanrecommended and not tangential tothe diaphragmatic cupola .Mistaken assessmentof :c• Pleural effusion• Alveolar consolidation• Alveolar-interstitialsyndromeBedside Chest Radiography in the Criticallyill02 09 2012
  3. 3. Risk of transportationLung Computed Tomography inthe Critically illhttp://www.reapitie-02 09 2012
  4. 4. Scanning Positions forChest Sonography in ICU
  5. 5. Normal Anatomy
  6. 6. Tissue pattern representative of AlveolarConsolidationPresence of hyperechoic punctiformimagesrepresentative of air bronchogramsPleuraleffusionLower lobe
  7. 7. the "seashore sign" (Fig.3).
  8. 8. Clinical applications of lung ultrasonography in theintensive care unit1. Diagnosis of pulmonary consolidation.2. Diagnosis of atelectasis3. Diagnosis of alveolar-interstitialsyndrome4. Differentiating between pulmonary oedema and ARDS5. Differentiating between pulmonary oedema and COPD6. Diagnosis of pulmonary embolism7. Diagnosis of pneumothorax8. Diagnosis and estimation of volume and nature of pleural effusion.9. Diagnostic and therapeutic ultrasound-guided thoracentesis.
  9. 9. Absent lung slidingExaggerated horizontal artifactsLoss of comet-tail artifactsBroadening of the pleural line to a bandThe key sonographic signs ofPneumothorax
  10. 10. the "seashore sign" (Fig.3).
  11. 11. Pulmonary Embolism
  12. 12. Schematic representation of the parenchymal, pleural and vascularfeatures associated with pulmonary embolism.(Angelika Reissig, ClausKroegel. Respiration2003;70:441-452)
  13. 13. Alveolar-interstitial syndrome
  14. 14. Multiple B-lines - « comet-tails » - interstitial edema(B1)7 mm apart « B lines » thickened interlobularseptaD Lichtenstein et al AJRCCM 156 : 1640-1646 , 1997JJR 25 05http://www.reapitie-http://www.reapitie- 02 09 2012
  15. 15. D Lichtenstein et al AJRCCM 156 : 1640-1646 , 199730 11 2011Coalescent B lines - « comet-tails » - alveolaredema3 mm apart « B lines » ground-glassareashttp://www.reapitie- 02 09 2012
  16. 16. (Chest. 2008; 133:836-837)© 2008 American College of Chest PhysiciansUltrasound: The Pulmonologist’s New BestFriendMomen M. Wahidi, MD, FCCP

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