Application of pulmonary ultrasound for respiratory failure in intensive care unit

This review is part of a series of articles on the use of ultrasound in the intensive care unit. This review aims to demonstrate the most up-to-date ultrasound applications relevant to respiratory failure assessment and management in the intensive care unit. Pulmonary ultrasound encompasses pleural, parenchymal, and respiratory muscle ultrasound. It can be used at every stage of a patient’s course, including assessment of undifferentiated respiratory failure, disease-specific measurements and manipulations, respiratory muscle function assessment, lung and diaphragmatic protective ventilation, and liberation from mechanical ventilation. Multiple protocols and conceptual frameworks have been designed to assist the evaluation and management of undifferentiated patients. Disease states for which there is specific evidence include acute respiratory distress syndrome, cardiogenic pulmonary edema, bacterial pneumonia, and respiratory muscle dysfunction. Extensive outcome data supports the routine use of lung ultrasound in each situation. Pulmonary ultrasound has a large body of evidence supporting its widespread adoption within intensive care units. It represents the most versatile, non-invasive tool available for respiratory failure management.