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Insights into Imaging

, Volume 5, Issue 2, pp 253–279

First Online: 12 February 2014Received: 26 September 2013Revised: 20 December 2013Accepted: 10 January 2014

Abstract

ObjectivesTo create a state-of-the-art overview of the new and expanding role of ultrasonography in clinical decision-making, intervention and management of the upper and lower airways, that is clinically relevant, up-to-date and practically useful for clinicians.

MethodsThis is a narrative review combined with a structured Medline literature search.

ResultsUltrasonography can be utilised to predict airway difficulty during induction of anaesthesia, evaluate if the stomach is empty or possesses gastric content that poses an aspiration risk, localise the essential cricothyroid membrane prior to difficult airway management, perform nerve blocks for awake intubation, confirm tracheal or oesophageal intubation and facilitate localisation of tracheal rings for tracheostomy. Ultrasonography is an excellent diagnostic tool in intraoperative and emergency diagnosis of pneumothorax. It also enables diagnosis and treatment of interstitial syndrome, lung consolidation, atelectasis, pleural effusion and differentiates causes of acute breathlessness during pregnancy. Patient safety can be enhanced by performing procedures under ultrasound guidance, e.g. thoracocentesis, vascular line access and help guide timing of removal of chest tubes by quantification of residual pneumothorax size.

ConclusionsUltrasonography used in conjunction with hands-on management of the upper and lower airways has multiple advantages. There is a rapidly growing body of evidence showing its benefits.

Teaching Points• Ultrasonography is becoming essential in management of the upper and lower airways.

• The tracheal structures can be identified by ultrasonography, even when unidentifiable by palpation.

• Ultrasonography is the primary diagnostic approach in suspicion of intraoperative pneumothorax.

• Point-of-care ultrasonography of the airways has a steep learning curve.

• Lung ultrasonography allows treatment of interstitial syndrome, consolidation, atelectasis and effusion.

KeywordsAirway management Intubation Intratracheal Tracheostomy Pneumothorax Ultrasonography AbbreviationsABCDAirway, breathing, circulation and disability

CMCricothyroid membrane

CTComputed tomography

EBUSEndobronchial ultrasound

EFASTExtended focused assessment with sonography for trauma

FASTFocused assessment with sonography for trauma

ICUIntensive care unit

ISInterstitial syndrome

LMALaryngeal mask airway

LUSLung ultrasound

NGTNasogastric tube

OSAObstructive sleep apnea OSA

PDTPercutaneous dilatational tracheostomy

USUltrasonography

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Autor: Michael S. Kristensen - Wendy H. Teoh - Ole Graumann - Christian B. Laursen

Fuente: https://link.springer.com/







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