Einsatz der Lungen- und Pleurasonographie in der Notfall- und Intensivmedizin

Mathis, Gebhard

Bedside lung ultrasound (LUS) in emergency rooms and intensive care units can serve as a tool to diagnose common lung pathologies, monitor their course and guide clinical management. LUS requires only a few minutes and is a useful extension of the physical examination. Fractures of the ribs as well as the sternum are seen well on ultrasound. Minute pleural fluids (effusion, hemtothorax) are detectable. LUS is able to detect the sound of lung water and thus to differentiate a cardiogenic pulmonary edema from chronic obstructive lung disease. Inflammatory lung diseases such as pleuritis and pneumonia are better seen than on chest X‑ray. LUS should replace chest X‑ray in the diagnosis of ambulant acquired pneumonia. In ventilator-associated pneumonia and atelectasis, LUS measures the presence of lung consolidation as well as dynamic changes und reventilation. A heart-lung-vessel integrated triple ultrasonography according to clinical findings can help with the diagnosis of pulmonary embolism and should be a necessary weapon for the physicians, especially in emergency departments.