Role of ultrasound in acute respiratory failure and in the weaning of mechanical ventilation

Med Intensiva (Engl Ed). 2023 Sep;47(9):529-542. doi: 10.1016/j.medine.2023.03.018. Epub 2023 Jul 5.

Abstract

Comprehensive ultrasound assessment has become an essential tool to facilitate the diagnosis and therapeutic management of critically ill patients with acute respiratory failure (ARF). There is evidence supporting the use of ultrasound for the diagnosis of pneumothorax, acute respiratory distress syndrome, cardiogenic pulmonary edema, pneumonia and acute pulmonary thromboembolism, and in patients with COVID-19. In addition, in recent years, the use of ultrasound to evaluate responses to treatment in critically ill patients with ARF has been developed, providing a noninvasive tool for titrating positive end-expiratory pressure, monitoring recruitment maneuvers and response to prone position, as well as for facilitating weaning from mechanical ventilation. The objective of this review is to summarize the basic concepts on the utility of ultrasound in the diagnosis and monitoring of critically ill patients with ARF.

Keywords: Acute respiratory failure; Critically ill; Echocardiography; Ecografía; Insuficiencia respiratoria aguda; Mechanical ventilation; Paciente crítico; Ventilación mecánica.

Publication types

  • Review

MeSH terms

  • COVID-19* / complications
  • COVID-19* / diagnostic imaging
  • Critical Illness
  • Humans
  • Respiration, Artificial
  • Respiratory Distress Syndrome* / diagnostic imaging
  • Respiratory Distress Syndrome* / therapy
  • Respiratory Insufficiency* / diagnostic imaging
  • Respiratory Insufficiency* / therapy
  • Ventilator Weaning