title: Ultrasound imaging and use of B-lines for functional lung evaluation in neurocritical care: a prospective, observational study.
abstract: BACKGROUND
  Lung ultrasound imaging can be used to evaluate pulmonary water content and pulmonary consolidation in ICU patients, but data from neurocritical care are lacking.
  
  
  OBJECTIVE
  To evaluate the utility of lung ultrasound to estimate the PaO2/FiO2 ratio and its diagnostic accuracy compared with chest radiograph and thoracic computed tomography (CT).
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  University hospital neurocritical care unit.
  
  
  METHODS
  Forty-five consecutive patients.
  
  
  METHODS
  The relationship between the number of B-lines and the PaO2/FiO2 ratio as measure of lung water content, and the diagnosis of pulmonary consolidation.
  
  
  RESULTS
  Evaluation of lung water content as determined by the number of 'B-lines' has a linear relationship with the PaO2/FiO2 ratio (r = -0.8; P < 0.01). Lung ultrasound has a diagnostic accuracy similar to that of chest radiograph (99 vs. 96%), using thoracic CT as the reference technique.
  
  
  CONCLUSIONS
  In neurocritical care, the use of lung ultrasound allows detection of increased lung water content when more than three 'B-lines' are present within the same lung field. This is associated with a reduction in PaO2/FiO2 ratio. Lung ultrasound can be used to diagnose pulmonary consolidation with an accuracy similar to the chest radiograph.
authors.affiliation: Section of Neuroanesthesia and Neurocritical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University of Rome, Rome, Italy. bilotta@tiscali.it
authors.forename: Federico
authors.initials: F
authors.lastname: Bilotta
authors.forename: Luigi D
authors.initials: LD
authors.lastname: Giudici
authors.forename: Ivan O
authors.initials: IO
authors.lastname: Zeppa
authors.forename: Carolina
authors.initials: C
authors.lastname: Guerra
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Stazi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rosa
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000737:chemistry; D011446:Prospective Studies; D013902:Radiography, Thoracic; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D010100:Oxygen