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Vol. 47. Issue 9.
Pages 529-542 (September 2023)
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Vol. 47. Issue 9.
Pages 529-542 (September 2023)
Update in intensive care medicine: ultrasound in the critically ill patient. Clinical applications
Role of ultrasound in acute respiratory failure and in the weaning of mechanical ventilation
Papel de la ecografía en la insuficiencia respiratoria aguda y en el weaning de la ventilación mecánica
Luis Zapataa,
Corresponding author

Corresponding author.
, Rafael Blancasb, Isabel Conejo-Márquezc, Marina García-de-Acilud
a Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
b Servicio de Medicina Intensiva, Hospital Universitario del Tajo, Universidad Alfonso X El Sabio, Aranjuez, Madrid, Spain
c Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, Spain
d Servicio de Medicina Intensiva, Hospital Universitario Parc Taulí, Sabadell, Barcelona, Spain
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Tables (2)
Table 1. Patterns and associated disease conditions according to the Blue protocol.
Table 2. Classification of lung aeration.
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Comprehensive ultrasound assessment has become an essential tool to facilitate the diagnosis and therapeutic management of critically ill patients with acute respiratory failure (ARF). There is evidence supporting the use of ultrasound for the diagnosis of pneumothorax, acute respiratory distress syndrome, cardiogenic pulmonary edema, pneumonia and acute pulmonary thromboembolism, and in patients with COVID-19. In addition, in recent years, the use of ultrasound to evaluate responses to treatment in critically ill patients with ARF has been developed, providing a noninvasive tool for titrating positive end-expiratory pressure, monitoring recruitment maneuvers and response to prone position, as well as for facilitating weaning from mechanical ventilation. The objective of this review is to summarize the basic concepts on the utility of ultrasound in the diagnosis and monitoring of critically ill patients with ARF.

Acute respiratory failure
Critically ill
Mechanical ventilation

La evaluación integral mediante ecografía se ha convertido en una herramienta indispensable para facilitar el diagnóstico y el manejo terapéutico en los pacientes críticos con insuficiencia respiratoria aguda (IRA). Existe evidencia que apoya el uso de la ecografía para el diagnóstico de neumotórax, síndrome de distrés respiratorio agudo, edema pulmonar cardiogénico, neumonía, tromboembolismo pulmonar agudo y el paciente con COVID-19. Además, en los últimos años, se ha desarrollado el uso de la ecografía para evaluar la respuesta a los tratamientos en los pacientes críticos con IRA, brindando una herramienta no invasiva para la titulación de la presión positiva al final de la espiración, monitorizar las maniobras de reclutamiento y la respuesta al prono, así como para facilitar la retirada de la ventilación mecánica. El objetivo de esta revisión es resumir los conceptos básicos sobre la utilidad de la ecografía en el diagnóstico y monitorización de los pacientes críticos con IRA.

Palabras clave:
Insuficiencia respiratoria aguda
Paciente crítico
Ventilación mecánica


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