title: Lung ultrasound: a promising tool to monitor ventilator-associated pneumonia in critically ill patients.
abstract: Ventilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection that is independently associated with mortality. Accurate diagnosis and timely treatment have been shown to improve the prognosis of VAP. Chest X-ray or computed tomography imaging are used for conventional assessment of VAP, but these methods are impractical for real-time measurement in critical patients. Therefore, lung ultrasound (LUS) has been increasingly used for the assessment of VAP in the ICU. Traditionally, LUS has seemed unsuitable for the detection of lung parenchyma owing to the high acoustic impedance of air; however, the fact that the reflection and reverberation in the detection region of the ultrasound reflect the underlying pathology of lung diseases has led to the increased use of ultrasound imaging as a standard of care supported by evidence-based and expert consensus in the ICU. Considering that any type of pneumonia causes air volume changes in the lungs, accumulating evidence has shown that LUS effectively measures the presence of VAP as well as dynamic changes in VAP. This review offers evidence for ultrasound as a noninvasive, easily repeatable, and bedside means to assess VAP; in addition, it establishes a protocol for qualitative and quantitative monitoring of VAP.
authors: Department of Intensive Care Unit, The Second Xiangya Hospital, Central South University, Changsha City, Hunan Province, China.
authors: Guyi
authors: G
authors: Wang
authors: Department of General Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. 183572401@qq.com.
authors: Xiaoying
authors: X
authors: Ji
authors: Department of General Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors: Yongshan
authors: Y
authors: Xu
authors: Department of Emergency, The Second Xiangya Hospital, Central South University, Changsha City, Hunan Province, China.
authors: Xudong
authors: X
authors: Xiang
mesh_terms: D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000639:trends; D008168:Lung / Q000000981:diagnostic imaging*; D008991:Monitoring, Physiologic / Q000379:methods* / Q000639:trends; D053717:Pneumonia, Ventilator-Associated / Q000000981:diagnostic imaging* / Q000517:prevention & control; D014463:Ultrasonography / Q000379:methods / Q000639:trends
keywords: Intensive care unit; Lung ultrasound; Ventilator-associated pneumonia