Monday, September 14, 2015

US-Derrame pleural

September 8, 2015 - By Michal Barrie
"In the undifferentiated ill patient, the cause of the pleural effusion is not always clear. Is it secondary to decompensated CHF or is this a parapneumonic effusion? Obviously the clinical history and exam, imaging studies, (and perhaps the other sonographic views we mentioned), labs studies, etc that would lead you to the most likely conclusion. But…
"Can bedside thoracic ultrasound diagnose a parapneumonic effusion? Or are we doomed to google Light’s criteria once more and prepare for a rather uncomfortable bedside procedure?"
It turns out that there have been a number of studies attempting to correlate the sonographic assessment of an exudative effusion and formal definition by Light’s criteria on thoracentesis. While clinical decision rules have not been studied in large prospective trials, the following are some features of thoracic ultrasound that have been commonly used to classify pleural effusions as transudative or exudative in nature."

No septationsAnatomySeptationsSeptations present
AnechoicB-ModeEchogenicityHypoechoic, heterogeneous internal echoes
< 3 mmCalipersPleural thickness>3 mm