Reporting focused lung ultrasound studies in critical care. Recommendations from the College of Intensive Care Medicine Ultrasound Special Interest Group

Abstract

Objective: To describe the recommended procedure and common ultrasonographic findings and present a framework for labelling, recording and reporting of images obtained during a focused lung ultrasound study. Background(s): Lung ultrasound is a widely utilised point-of-care investigation in acute care, providing valuable diagnostic information in patients with dyspnoea or haemodynamic instability. It has a number of recognised advantages and has been incorporated into a variety of clinical algorithms. Recommendations for performing lung ultrasound and description of common artefacts are readily available; however, there is a lack of a recognised framework for labelling and reporting a lung ultrasound study. Standardised recording, labelling and reporting are important clinically, while promoting consistency, quality assurance, teaching and research opportunities. Documenting lung ultrasound also has potential medico-legal implications. Result(s): For focused lung ultrasound, an extended bilateral four-quadrant approach is recommended. Acquired images and loops should be clearly labelled identifying left or right, anterior or lateral and inferior, superior or posterior locations. 2D loops should be of sufficient length to clearly demonstrate pleural sliding, complemented by M-mode stills if required. Reports should provide information regarding the presence or absence of an intact pleural interface, the presence or absence and the size and nature of pleural collections as well as any parenchymal artefacts or consolidation, in all examined locations. It is important to use internationally accepted terminology to describe findings, and it is also recommended to conclude the report with a clear summary that can be interpreted by healthcare providers without specific training in lung ultrasound. Copyright © 2019 Australasian Society for Ultrasound in Medicine