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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Saturday, May 21, 2016

US of extravascular lung water

Picano E and Pellikka P - European Heart Journal  - Received December 9, 2015 - Revision received March 17, 2016 - Accepted April 3, 2016.
"B-lines are a sign of interstitial syndrome of mixed origin (fibrosis, inflammation, and congestion), and in acute or chronic heart failure patients they mostly represent the direct, positive image of lung water, for a long time a forbidden fruit for the clinical cardiologist. Through the lung water teaser, the cardiologist will become familiar with the new diagnostic world of LUS, a friendly neighbour of transthoracic echocardiography, of critical help in many different and frequent clinical situations, from diagnosis and semi-quantification of pleural effusion to fluid management in cardiogenic shock to pneumothorax identification in differential diagnosis of dyspnoea. The rapidly dynamic nature of B-lines separates wet B-lines made by water (decreased by diuretics) from dry B-lines made of connective tissue. B-lines can be used anywhere (even in extreme environmental conditions with pocket size devices), by anyone (including novice sonographer) on anybody (since the superficial acoustic window that is required usually is feasible even when echocardiography is not feasible). Rarely, in cardiac imaging, we have so much diagnostic gain with so little technological, training, and time pain. Lung ultrasound can quantify lung oedema noninvasively in real time, even at an early subclinical stage, with user-friendly, low cost, radiation-free, and direct imaging of EVLW."