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Sudanese chest sonography workshop (Sonography in critical ill patients)
1.
2. Chest Sonography in Critically
Ill Patients
Gamal Rabie Agmy ,MD ,FCCP
Professor of Chest Diseases, Assiut University
ERS National Delegate of Egypt
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4. c
At the bedside, chest radiography remains the reference for lung imaging in
critically ill patients. However, radiographical images are often of
limited quality
• Movements of the chest wall
• Film cassette posterior to the
thorax
• X-ray beam originating anteriorly, at
a shorter distance than
recommended and not tangential to
the diaphragmatic cupola .
Mistaken assessment
of :
c
• Pleural effusion
• Alveolar consolidation
• Alveolar-interstitial
syndrome
Bedside Chest Radiography in the Critically
ill
02 09 2012
19. Tissue pattern representative of Alveolar
Consolidation
Presence of hyperechoic punctiform
imagesrepresentative of air bronchograms
Pleural
effusion
Lower lobe
23. Clinical applications of lung ultrasonography in the
intensive care unit
1. Diagnosis of pulmonary consolidation.
2. Diagnosis of atelectasis
3. Diagnosis of alveolar-interstitialsyndrome
4. Differentiating between pulmonary oedema and ARDS
5. Differentiating between pulmonary oedema and COPD
6. Diagnosis of pulmonary embolism
7. Diagnosis of pneumothorax
8. Diagnosis and estimation of volume and nature of pleural effusion.
9. Diagnostic and therapeutic ultrasound-guided thoracentesis.
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34. Absent lung sliding
Exaggerated horizontal artifacts
Loss of comet-tail artifacts
Broadening of the pleural line to a band
The key sonographic signs of
Pneumothorax
48. Schematic representation of the parenchymal, pleural and vascular
features associated with pulmonary embolism.(Angelika Reissig, Claus
Kroegel. Respiration2003;70:441-452)