Lungultraljud – en uppseglande metod vid dyspné och hjärtsvikt

• Ultrasound plays an important role in several medical fields. The heart was the first organ for which ultrasound gained clinical utility, followed by obstetric and gynecological applications. Shortly thereafter, abdominal organs and blood vessels became targets for ultrasound examination. The lung was long considered inaccessible for ultrasound due to its high air content. Work since the 1990s has however established a role for lung ultrasound, in leveraging several technical artefacts generated in the normal lung and in conditions with reduced air content, to allow rapid diagnosis of interstitial fluid accumulation, pneumothorax, pneumonia among others. In this article, we provide an overview of the potential of lung ultrasound, particularly as a promising method for assessment of patients presenting with acute dyspnea in the emergency department and for monitoring residual fluid in patients with decompensated heart failure. We also discuss limitations and caveats of the method.

• Lungultraljud har visat god precision och reproducerbarhet som diagnostiskt komplement till klinisk undersökning vid akut dyspné. Lungultraljud utförs bedside och är relativt lätt att lära sig, men kräver träning och strukturerat utförande för att inte resultera i felaktiga diagnoser.Lungultraljud baseras till största delen på tolkning av artefakter. Vid en normalt luftfylld lunga bildas horisontella reverberationsartefakter kallade A-linjer. Vid extracellulärt vätskeutträde uppstår vertikala B-linjer, vilka reducerar de normala A-linjerna.Lungultraljud med räkning av antal B-linjer har visat sig vara lovande för värdering av interstitiellt ödem vid hjärtsvikt, men ytterligare studier behövs.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Publication and Content Type

art (subject category)

ref (subject category)