title: Chest ultrasound in acute respiratory distress syndrome.
abstract: OBJECTIVE
  This review discusses the role of chest ultrasound in diagnosis and management of acute respiratory distress syndrome (ARDS) and the most recent technical progresses in this field.
  
  
  RESULTS
  Clinically, suspected ARDS can be easily confirmed by lung ultrasonography through the recognition of a typical pattern characterized by B-lines, spared areas, pleural line thickening, and subpleural consolidations. A visual score based on number and thickness of B-lines permits a semiquantitative evaluation of the amount of extravascular lung water and lung density. Recently, a quantitative lung ultrasound method has been proposed. The heart may be also involved in ARDS either primarily or by the application of positive pressure ventilation. The incidence of acute cor pulmonale during ARDS is, even if under protective ventilation, not negligible. The use of echocardiography combined with lung ultrasound is important for early detection of cor pulmonale, identification of the best ventilator strategy to preserve heart-to-lung interaction, and prediction of weaning success.
  
  
  CONCLUSIONS
  An ultrasound-integrated approach combining lung ultrasound and echocardiography should be recommended as a suitable technique to manage ARDS during diagnosis, mechanical ventilation setting, and weaning.
authors.affiliation: aDipartimento Cardio-Nefro-Polmonare, Sezione Terapia Intensiva Cardiochirurgica, Azienda Ospedaliero Universitaria di Parma, Parma bDipartimento di Anestesia e Rianimazione, E.O. Ospedali Galliera cDipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione, Università degli Studi di Genova, IRCCS AOU San Martino, IST, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Corradi
authors.forename: Claudia
authors.initials: C
authors.lastname: Brusasco
authors.forename: Paolo
authors.initials: P
authors.lastname: Pelosi
mesh_terms: D000328:Adult; D004452:Echocardiography; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D011175:Positive-Pressure Respiration / Q000379:methods*; D011654:Pulmonary Edema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011660:Pulmonary Heart Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy