Ultrasonographic finding of lung sliding in patients on mechanical ventilation with alveolar-interstitial syndrome.
OBJECTIVE
To determine the visibility of pleural lung sliding in alveolar-interstitial syndrome (AIS) in patients on mechanical ventilation at two different time points, as a confirmatory ultrasonographic method for excluding pneumothorax.


METHODS
Fifty-two mechanically ventilated patients in the semirecumbent position in a surgical/neurosurgical intensive care unit with ultrasonographic lung 'comet tails' in three upper anterolateral intercostal spaces, indicating the presence of AIS, were scanned for lung sliding in the same three intercostal spaces with a linear 5-10 MHz transducer after starting mechanical ventilation and on weaning trials. Pneumothorax and atelectasis were excluded by chest radiograph.


RESULTS
Absent lung sliding was found in 22.7% of intercostal spaces scanned after starting mechanical ventilation and in 21.2% of scans taken on weaning trials. The lowest invisible rate was in patients with acute heart failure and the highest in patients with acute respiratory distress syndrome.


CONCLUSIONS
Lung sliding specificity in AIS during mechanical ventilation was 78%. Our opinion is that different levels of airway pressure between starting mechanical ventilation and weaning trials have no influence on lung sliding visibility.
Rode
Bojan
B
Department of Anesthesiology and Intensive Care, 'Sisters of Mercy' University Hospital, Zagreb, Croatia. bojan.rode@zg.t-com.hr
Vučić
Marinko
M
Siranović
Mladen
M
Kovač
Nataša
N
Kelečić
Mijo
M
Gopčević
Aleksandar
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D015300:Ventilator Weaning; D055397:Ventilator-Induced Lung Injury / Q000000981:diagnostic imaging / Q000209:etiology