Ultralydsscanning af Lunger

Ultralydsscanning af lunger Personlig baggrund Ultralydsscanning af lunger - baggrund Pneumothorax Interstitielt syndrom Perspektiv

Ultralydsscanning af lunger - baggrund Ultrasound imaging is not useful for evaluation of the pulmonary parenchyma TR Harrison, Principles of Internal Medicine 2001. The utility of thoracic ultrasound for diagnosing a pneumothorax is limited in hospital practice due to the ready availability of chest x-rays (CXR) and conflicting data from published reports - Havelock T, Teoh R, Laws D, et al. Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010. Thorax 2010;65

Ultralydsscanning af lunger - baggrund Historie: - Dénier A. Les ultrasons, leur application au diagnostic. Presse Méd 1946;22:307-308 - Joyner C, Miller LD, Dudrick SJ et al. Reflected ultrasound in the detection of pulmonary embolism. Trans Assn Am Phys 1966;79:262-77 - Rantanen NW. Diseases of the thorax. Vet Clin North Am Equine Pract. 1986 Apr;2(1):49-66 - Dorne HL. Differentiation of pulmonary parenchymal consolidation from pleural disease using the sonographic fluid bronchogram. Radiology. 1986 Jan;158(1):41-2 - Lichtenstein D, Mezière G, Biderman P, Gepner A, Barré O. The Comet-tail Artifact. An Ultrasound Sign of Alveolar-Interstitial Syndrome. Am J Respir Crit Care Med 1997;156:1640-1646 - Kirkpatrick AW, Nicolaou S, Rowan K. Thoracic sonography for pneumothorax: the clinical evaluation of an operational space medicine spin-off. Acta Astronaut. 2005 May-Jun;56(9-12):831-8

Ultralydsscanning af lunger - baggrund 4 Lungeultralydsskoler: - Den franske - Den germanske - Den italienske - Den nordamerikanske

Den franske skole Intensiv patienter: - Pneumothorax - KOL vs lungeødem - ARDS - Atelektase / konsolidering - Fejlintubation - Pneumoni - Lungeemboli - Effusion - Nomenklatur ala France

Den germanske skole Lungemedicinske patienter: - Lungeemboli - Pneumoni - CEUS

Den italienske skole Kardiologiske patienter: - Lungeødem/stase - Brystsmerter - Interstitielle lungesygdomme - Pædiatri

Den nordamerikanske skole Traumatologi / wilderness: - Pneumothorax - Højde syge - NASA

Den danske skole? Ugeskr Læger 2009;171(36):2541: LUS hos den kritisk syge patient. I gang værende projekter: - Skejby: Størrelse af pneumothorax, FATE - OUH: Afd J /AMA / SDU

Konsensus Rapport 2011? - Pneumothorax - KOL / astma - ARDS - Atelektase / konsolidering - Fejlintubation - Effusion - Pneumoni - Lungeemboli - Lungeødem/stase - Brystsmerter - Interstitielle lungesygdomme

Pneumothorax Key signs ved pneumothorax diagnostik: - Lungsliding - A-linjer - B-linjer - Lung point - Lung pulse

Pneumothorax Key signs ved pneumothorax diagnostik: - Lungsliding (rule-out) - A-linjer (uspecifikt) - B-linjer (rule-out) - Lung point (rule-in) - Lung pulse (rule-out)

Pneumothorax Lungsliding Lichtenstein et al. Chest 1995;108:1345-1348.

Pneumothorax Lungsliding: - M-mode: Seashore sign Lichtenstein et al. Chest 1995;108:1345-1348.

Pneumothorax Ingen lungsliding: - Tydelige A-linjer - M-mode: Stratosfere sign Lichtenstein et al. Chest 1995;108:1345-1348.

Lichtenstein et al. Intensive Care Med 2000;26:1434-1440. Lung Point

Lung Pulse Pneumothorax eller fejlintubation? Lichtenstein et al. Intensive Care Med 2003;29:2187-2192.

Lichtenstein et al. Intensive Care Med 2003;29:2187-2192. Lung Pulse

Pneumothorax Chest Sonography EFSUMB European course book.

Interstitielt syndrom Lichtenstein et al. Am J Respir Crit Care Med 1997;156:1640-1646.

Interstitielt syndrom Sensitivitet: 93,4% Specificitet: 93,0% Lichtenstein et al. Am J Respir Crit Care Med 1997;156:1640-1646.

Lichtenstein et al. Int Care Med 1998;24:1331-1334. Interstitielt syndrom

Ultralydsscanning af lunger Personlig baggrund Ultralydsscanning af lunger - baggrund Pneumothorax Interstitielt syndrom Perspektiv: - Diagnostik - Follow up

Diagnostisk Lungeultralyd Reissig et al. Pneumonologie 2007;61:20-40

Mathis et al. Chest 2005;128:1531-1538. Lungeinfarkt

Lichtenstein et al. Chest 2008;134:117-125.

Reissig et al. Pneumonologie 2007;61:20-40

Ultralydsscanning af lunger Personlig baggrund Ultralydsscanning af lunger - baggrund Pneumothorax Interstitielt syndrom Perspektiv: - Diagnostik - Follow up

Lekture

Europæiske Kurser WinFocus Certified Course in Emergency Lung Ultrasound (16-17 Maj, Skejby) WinFocus Scandinavia (10-12 November, Skejby) ÖGUM Euroson School (23-24 September 2011, Prag)