The Role of B-Line Artifacts on Lung Ultrasound in Critically Ill Patients
1Department of Anesthesiology, Reanimatology, Intensive Care and Emergency Medicine, Faculty of Medicine, University of Rijeka, Croatia
2Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Cantonal Hospital Mostar, Bosnia and Herzegovina
3Department of Clinical Medical Science II, Faculty of Health Studies, University of Rijeka, Croatia
DOI: 10.22514/sv.2020.16.0041 Vol.16,Issue 2,October 2020 pp.1-7
Published: 28 October 2020
Lung ultrasound (LUS) is becoming a valuable tool in assessing patients in the ER, ICU, and on the hospital wards because it is a simple, fast and harmless technique. One of the most distinct artefacts seen with LUS are B-lines, hyperechoic laser-like lines that form in the presence of thickened interlobular septa due to alveo-interstitial syndrome. Many researches have been conducted recently with a goal of correlating B-lines to specific known parameters such as EVLW, PAOP, lung density, and parameters of cardiac failure, either in quantitative or semiquantitative manner. This paper is a short overview of the present known correlations, shortcomings of conducted investigations and differential diagnosis problems and exceptions of B-line artefacts in everyday clinical practice.
Point-of-care-ultrasound (POCUS), Lung ultrasound, B-lines
Ana Pičuljan,Alen Protić,Mehmed Haznadar,Alan Šustić. The Role of B-Line Artifacts on Lung Ultrasound in Critically Ill Patients. Signa Vitae. 2020. 16(2);1-7.
 Gargani L, Volpicelli G. How i do it: Lung ultrasound. Cardiovasc Ultrasound. 2014;12:1–10.
 Ricci F, Aquilani R, Radico F, et al. Role and importance of ultrasound lung comets in acute cardiac care. Eur Hear journal Acute Cardiovasc care. 2015;4:103–112.
 Bianco F, Bucciarelli V, Ricci F, et al. Lung ultrasonography: A practical guide for cardiologists. J Cardiovasc Med. 2017;18:501–509.
 Baldi G, Gargani L, Abramo A, et al. Lung water assessment by lung ultrasonography in intensive care: a pilot study. Intensive Care Med. 2013;39:74–84.
 Enghard P, Rademacher S, Nee J, et al. Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients. Crit Care. 2015;19:36.
 Volpicelli G, Mussa A, Garofalo G, et al. Bedside lung ultrasound in the assessment of alveolar-interstitial syndrome. Am J Emerg Med. 2006;24:689–696.
 Summerfield DT, Johnson BD. Lung Ultrasound Comet Tails - Technique and Clinical Significance. In: Squeri A, editor. Hot Topics in Echocardio-graphy. IntechOpen; 2013. p. 51–64.
 Jambrik Z, Monti S, Coppola V, et al. Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol. 2004;93:1265–1270.
 Aziz SG, Patel BB, Ie SR, et al. The lung point sign, not pathognomonic of a pneumothorax. Ultrasound Q. 2016;32:277–279.
 Volpicelli G, Skurzak S, Boero E, et al. Lung Ultrasound Predicts Well Extravascular Lung Water but Is of Limited Usefulness in the Prediction of Wedge Pressure. Anesthesiology. 2014;121:320–327.
 Raheja R, Brahmavar M, Joshi D, et al. Application of Lung Ultrasound in Critical Care Setting: a Review. Cureus. 2019;11:e5233.
 Cox EGM, Wiersema R, Wong A, et al. Six versus eight and twenty-eight scan sites for B-line assessment: differences in examination time and findings. Intensive Care Med. 2020;46:1063–1064.
 Šustić M, Šustić A. Unrecognized B line mimicked pneumothorax on M mode ultrasound. Signa Vitae. 2018;14:92.
 Wang YK, Gargani L, Barskova T, et al. Usefulness of lung ultrasound B-lines in connective tissue disease-associated interstitial lung disease: A literature review. Arthritis Res Ther. 2017;19:1–9.
 Miglioranza MH, Gargani L, Sant’Anna RT, et al. Lung Ultrasound for the Evaluation of Pulmonary Congestion in Outpatients. JACC Cardiovasc Imaging. 2013;6:1141–1151.
 Ferré A, Guillot M, Lichtenstein D, et al. Lung ultrasound allows the diagnosis of weaning-induced pulmonary oedema. Intensive Care Med. 2019;45:601–608.
 Sperandeo M, Trovato GM, Catalano D. Quantifying B-Lines on Lung Sonography: Insufficient Evidence as an Objective, Constructive, and Educational Tool. J Ultrasound Med. 2014;33:362.
 Haaksma ME, Smit JM, Heldeweg MLA, et al. Lung ultrasound and B-lines: B careful! Intensive Care Med. 2020;46:544–545.
 Pičuljan A, Šustić M, Brumini G, et al. Reliability of B-line quantification by different-level observers and a software algorithm using point-of-care lung ultrasound. J Clin Monit Comput. 2019. doi: 10.1007/s10877-019-00440-7.
Science Citation Index Expanded (SciSearch) The Science Citation Index (SCI) is a citation index originally produced by the Institute for Scientific Information (ISI) and created by Eugene Garfield. It (Science Citation Index Expanded) covers more than 8,500 notable and significant journals, across 150 disciplines in science and technology, from 1900 to the present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.