Lungensonografie auf der Intensivstation – Schritt für Schritt

Im Statement der European Respiratory Society (ERS) zum Thoraxultraschall wird festgestellt, dass dieser ein essenzielles Hilfsmittel für den Pneumologen ist [1]. Auch im intensivmedizinischen Umfeld gewinnt das Verfahren an Relevanz. In diesem Artikel wird eine vereinfachte Abfolge von Untersuchungsschritten mit einem komprimierten Interpretationsansatz vorgestellt.

Publication History

Article published online:
08 April 2025

• Literatur

• 1 Laursen CB, Clive A, Hallifax R. et al. European Respiratory Society statement on thoracic ultrasound. Eur Respir J 2021; 57
• 2 Winkler MH, Touw HR, van de Ven PM. et al. Diagnostic accuracy of chest radiograph, and when concomitantly studied lung ultrasound, in critically Ill patients with respiratory symptoms: a systematic review and meta-analysis. Crit Care Med 2018; 46: e707-e714
• 3 Mongodi S, Bouhemad B, Orlando A. et al. Modified lung ultrasound score for assessing and monitoring pulmonary aeration. Ultraschall Med 2017; 38: 530-537
• 4 Duggan NM, Goldsmith AJ, Saud AAA. et al. Optimizing lung ultrasound: the effect of depth, gain and focal position on sonographic B-lines. Ultrasound Med Biol 2022; 48: 1509-1517
• 5 Heldeweg MLA, Smit MR, Kramer-Elliott SR. et al. Lung ultrasound signs to diagnose and discriminate interstitial syndromes in ICU patients: a diagnostic accuracy study in two cohorts. Crit Care Med 2022; 50: 1607-1617
• 6 Kraaijenbrink BVC, Mousa A, Bos LD. et al. Defining basic (lung) ultrasound skills: not so basic after all?. Int Care Med 2022; 48: 628-629
• 7 Demi L, Wolfram F, Klersy C. et al. New international guidelines and consensus on the use of lung ultrasound. J Ultrasound Med 2023; 42: 309-344
• 8 Balik M, Plasil P, Waldauf P. et al. Ultrasound estimation of volume of pleural fluid in mechanically ventilated patients. Int Care Med 2006; 32: 318
• 9 Bouhemad B, Mongodi S, Via G. et al. Ultrasound for „lung monitoring“ of ventilated patients. Anesthesiology 2015; 122: 437-447
• 10 Chiumello D, Mongodi S, Algieri I. et al. Assessment of lung aeration and recruitment by CT scan and ultrasound in acute respiratory distress syndrome patients. Crit Care Med 2018; 46: 1761-1768
• 11 Smit MR, Hagens LA, Heijnen NFL. et al. DARTS Consortium members. Lung ultrasound prediction model for acute respiratory distress syndrome: a multicenter prospective observational study. Am J Respir Crit Care Med 2023; 207: 1591-1601
• 12 Pisani L, Vercesi V, van Tongeren PSI. et al. Lung Ultrasound Consortium. The diagnostic accuracy for ARDS of global versus regional lung ultrasound scores – a post hoc analysis of an observational study in invasively ventilated ICU patients. Int Care Med Exp 2019; 7 (Suppl. 1) 44
• 13 Haaksma ME, Smit JM, Heldeweg MLA. et al. Extended lung ultrasound to differentiate between pneumonia and atelectasis in critically Ill patients: a diagnostic accuracy study. Crit Care Med 2022; 50: 750-759
• 14 Bouhemad B, Brisson H, Le-Guen M. et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med 2011; 183: 341-347
• 15 Soummer A, Perbet S, Brisson H. Lung Ultrasound Study Group. et al. Ultrasound assessment of lung aeration loss during a successful weaning trial predicts postextubation distress. Crit Care Med 2012; 40: 2064-2072
• 16 Bouhemad B, Mojoli F, Nowobilski N. et al. Use of combined cardiac and lung ultrasound to predict weaning failure in elderly, high-risk cardiac patients: a pilot study. Int Care Med 2020; 46: 475-484