2. Chest Sonography in Critically
Ill Patients
Gamal Rabie Agmy ,MD ,FCCP
Professor of Chest Diseases, Assiut University

4. A common language: Color Coding
Black Grey White

5. Ultrasound profiles.
Lichtenstein D A , Mezière G A Chest 2008;134:117-125

7. Tissue pattern representative of Alveolar
Consolidation
Presence of hyperechoic punctiform
imagesrepresentative of air bronchograms
Pleural
effusion
Lower lobe

9. Scanning Positions for
Chest Sonography in ICU

13. Normal Anatomy

21. Tissue pattern representative of Alveolar
Consolidation
Presence of hyperechoic punctiform
imagesrepresentative of air bronchograms
Pleural
effusion
Lower lobe

24. the "seashore sign" (Fig.3).

25. Clinical applications of lung ultrasonography in the
intensive care unit
1. Diagnosis of pulmonary consolidation.
2. Diagnosis of atelectasis
3. Diagnosis of alveolar-interstitialsyndrome
4. Differentiating between pulmonary oedema and ARDS
5. Differentiating between pulmonary oedema and COPD
6. Diagnosis of pulmonary embolism
7. Diagnosis of pneumothorax
8. Diagnosis and estimation of volume and nature of pleural effusion.
9. Diagnostic and therapeutic ultrasound-guided thoracentesis.

36. Absent lung sliding
Exaggerated horizontal artifacts
Loss of comet-tail artifacts
Broadening of the pleural line to a band
The key sonographic signs of
Pneumothorax

40. the "seashore sign" (Fig.3).

49. Pulmonary Embolism

50. Schematic representation of the parenchymal, pleural and vascular
features associated with pulmonary embolism.(Angelika Reissig, Claus
Kroegel. Respiration2003;70:441-452)

52. Alveolar-interstitial syndrome

57. Multiple B-lines - « comet-tails » - interstitial edema
(B1)
7 mm apart « B lines » thickened interlobular
septa
D Lichtenstein et al AJRCCM 156 : 1640-1646 , 1997JJR 25 05http://www.reapitie-
http://www.reapitie- 02 09 2012

58. D Lichtenstein et al AJRCCM 156 : 1640-1646 , 199730 11 2011
Coalescent B lines - « comet-tails » - alveolar
edema
3 mm apart « B lines » ground-glass
areas
http://www.reapitie- 02 09 2012

71. (Chest. 2008; 133:836-837)
© 2008 American College of Chest Physicians
Ultrasound: The Pulmonologist’s New Best
Friend
Momen M. Wahidi, MD, FCCP