LUNG ULTRASOUND: CONTEMPORARY POSSIBILITIES - ORIGINAL PAPER

Keywords: Lung Ultrasound, Ultrasonography, Innovative Methods, Artifacts

Abstract

Introduction: For many years, lung ultrasound was considered a controversial, even impossible, technique. Years of research have accumulated compelling evidence for the usefulness of this technique in clinical practice, and its user base has gradually expanded. The greatest boom in this technique occurred with the onset of the COVID-19 pandemic, when it proved extremely effective in monitoring its progression.

Methods: Our personal experience confronted with literature research by Pubmed, Web of Science, Google Schoolar.

Results: The lack of standardized definitions and nomenclature has led to a certain dissonance in publications and controversy, which is evident when reviewing the literature. Other controversial issues include the type of examination equipment used, the measurement of artifacts and the accurate assessment of their sonomorphology, as well as the extension of the examination to include additional elements such as the diaphragm. An issue repeatedly raised in publications is the need to develop a system of training and certification in lung ultrasound skills, which would allow for the standardization of the technique, nomenclature, and diagnostic criteria. Another problem is the lack of inclusion of lung ultrasound in the practice guidelines of various scientific societies in many countries, which is the subject of work by national and international ultrasound associations.

Conclusions: Despite some controversy, lung ultrasound is a valuable tool in everyday clinical practice with great potential for development.

References

Nelson BP, Sanghvi A. Out of hospital point of care ultrasound: current use models and future directions. Eur J Trauma Emerg Surg. 2016 Apr;42(2):139-50. doi: 10.1007/s00068-015-0494-z. Epub 2015 Feb 10. PMID: 26038015.

Gettle LM, Revzin MV. Innovations in Vascular Ultrasound. Radiol Clin North Am. 2020 Jul;58(4):653-669. doi: 10.1016/j.rcl.2020.03.002. PMID: 32471536.

Kaiser U, Herr W, Greiner B, Stroszczynski C, Jung EM. Mobile handheld ultrasound with VScan Air for the diagnosis of deep vein thrombosis. Clin Hemorheol Microcirc. 2023;83(2):149-161. doi: 10.3233/CH-221598. PMID: 36278343.

Smallwood N, Dachsel M. Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med (Lond). 2018 Jun;18(3):219-224. doi: 10.7861/clinmedicine.18-3-219. PMID: 29858431; PMCID: PMC6334078.

Bledsoe A, Zimmerman J. Ultrasound: The New Stethoscope (Point-of-Care Ultrasound). Anesthesiol Clin. 2021 Sep;39(3):537-553. doi: 10.1016/j.anclin.2021.03.011. Epub 2021 Jul 12. PMID: 34392884.

Pedersen PC, Ozcan HS. Ultrasound properties of lung tissue and their measurements. Ultrasound Med Biol. 1986 Jun;12(6):483-99. doi: 10.1016/0301-5629(86)90220-6. PMID: 3523923.

Reissig A, Kroegel C. Transthoracic sonography of diffuse parenchymal lung disease: the role of comet tail artifacts. J Ultrasound Med. 2003 Feb;22(2):173-80. doi: 10.7863/jum.2003.22.2.173. PMID: 12562122.

Volpicelli G. Lung sonography. J Ultrasound Med. 2013 Jan;32(1):165-71. doi: 10.7863/jum.2013.32.1.165. PMID: 23269722.

Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008 Jul;134(1):117-25. doi: 10.1378/chest.07-2800. Epub 2008 Apr 10. Erratum in: Chest. 2013 Aug;144(2):721. PMID: 18403664; PMCID: PMC3734893.

Jackson K, Butler R, Aujayeb A. Lung ultrasound in the COVID-19 pandemic. Postgrad Med J. 2021 Jan;97(1143):34-39. doi: 10.1136/postgradmedj-2020-138137. Epub 2020 Sep 7. PMID: 32895294; PMCID: PMC10016966.

Alilio PM, Ebeling-Koning NE, Roth KR, Desai T. Lung point-of-care (POCUS) ultrasound in a pediatric COVID-19 case. Radiol Case Rep. 2020 Nov;15(11):2314-2318. doi: 10.1016/j.radcr.2020.09.007. Epub 2020 Sep 7. PMID: 32922585; PMCID: PMC7476498.

Grymiński J. Zastosowanie metody ultradźwiekowej w diagnostyce chorób opłucnej [Use of the ultrasound method in the diagnosis of pleural diseases]. Gruzlica. 1971 Jul;39(7):694-9. Polish. PMID: 5117149.

Kosiak W. Sonography of iatrogenic pneumothorax in pediatric patients. J Ultrason. 2013 Dec;13(55):379-93. doi: 10.15557/JoU.2013.0041. Epub 2013 Dec 30. PMID: 26675373; PMCID: PMC4579669.

Dietrich CF, Buda N, Ciuca IM, Dong Y, Fang C, Feldkamp A, Jüngert J, Kosiak W, Mentzel HJ, Pienar C, Rabat JS, Rafailidis V, Schrading S, Schreiber-Dietrich D, Jaworska J. Lung ultrasound in children, WFUMB review paper (part 2). Med Ultrason. 2021 Nov 25;23(4):443-452. doi: 10.11152/mu-3059. Epub 2021 Mar 3. PMID: 33657190.

Buda N, Kosiak W, Wełnicki M, Skoczylas A, Olszewski R, Piotrkowski J, Skoczyński S, Radzikowska E, Jassem E, Grabczak EM, Kwaśniewicz P, Mathis G, Toma TP. Recommendations for Lung Ultrasound in Internal Medicine. Diagnostics (Basel). 2020 Aug 16;10(8):597. doi: 10.3390/diagnostics10080597. PMID: 32824302; PMCID: PMC7460159.

Targhetta R, Chavagneux R, Bourgeois JM, Dauzat M, Balmes P, Pourcelot L. Sonographic approach to diagnosing pulmonary consolidation. J Ultrasound Med. 1992 Dec;11(12):667-72. doi: 10.7863/jum.1992.11.12.667. PMID: 1494199.

Copetti R, Cominotto F, Meduri S, Orso D. The "Survived Lung:" An Ultrasound Sign of "Bubbly Consolidation" Pulmonary Infarction. Ultrasound Med Biol. 2020 Sep;46(9):2546-2550. doi: 10.1016/j.ultrasmedbio.2020.04.036. Epub 2020 Jun 4. PMID: 32507699.

Quick AE, Ollivett TL, Kirkpatrick BW, Weigel KA. Genomic analysis of bovine respiratory disease and lung consolidation in preweaned Holstein calves using clinical scoring and lung ultrasound. J Dairy Sci. 2020 Feb;103(2):1632-1641. doi: 10.3168/jds.2019-16531. Epub 2019 Nov 20. PMID: 31759603.

Dicker SA. Lung Ultrasound for Pulmonary Contusions. Vet Clin North Am Small Anim Pract. 2021 Nov;51(6):1141-1151. doi: 10.1016/j.cvsm.2021.07.001. Epub 2021 Sep 11. PMID: 34521570.

Johannessen Ø, Claggett B, Lewis EF, Groarke JD, Swamy V, Lindner M, Solomon SD, Platz E. A-lines and B-lines in patients with acute heart failure. Eur Heart J Acute Cardiovasc Care. 2021 Oct 27;10(8):909-917. doi: 10.1093/ehjacc/zuab046. PMID: 34160009; PMCID: PMC8677442.

Seibel A, Zechner PM, Berghold A, Holter M, Braß P, Michels G, Leister N, Gemes G, Donauer R, Giebler RM, Sakka SG. B-Lines for the assessment of extravascular lung water: Just focused or semi-quantitative? Acta Anaesthesiol Scand. 2020 Aug;64(7):953-960. doi: 10.1111/aas.13586. Epub 2020 Apr 14. PMID: 32236940.

Martelius L, Heldt H, Lauerma K. B-Lines on Pediatric Lung Sonography: Comparison With Computed Tomography. J Ultrasound Med. 2016 Jan;35(1):153-7. doi: 10.7863/ultra.15.01092. Epub 2015 Dec 11. PMID: 26657749.

Hasan AA, Makhlouf HA. B-lines: Transthoracic chest ultrasound signs useful in assessment of interstitial lung diseases. Ann Thorac Med. 2014 Apr;9(2):99-103. doi: 10.4103/1817-1737.128856. PMID: 24791173; PMCID: PMC4005169.

Francisco MJ Neto, Rahal A Junior, Vieira FA, Silva PS, Funari MB. Advances in lung ultrasound. Einstein (Sao Paulo). 2016 Jul-Sep;14(3):443-448. doi: 10.1590/S1679-45082016MD3557. PMID: 27759836; PMCID: PMC5234763.

Trias-Sabrià P, Dorca Duch E, Molina-Molina M, Aso S, Díez-Ferrer M, Marín Muñiz A, Bordas-Martínez J, Sabater J, Luburich P, Del Rio B, Solanich X, Dorca J, Santos S, Suárez-Cuartin G. Radio-Histological Correlation of Lung Features in Severe COVID-19 Through CT-Scan and Lung Ultrasound Evaluation. Front Med (Lausanne). 2022 Apr 19;9:820661. doi: 10.3389/fmed.2022.820661. PMID: 35514757; PMCID: PMC9063463.

Jaworska J, Buda N, Ciuca IM, Dong Y, Fang C, Feldkamp A, Jüngert J, Kosiak W, Mentzel HJ, Pienar C, Rabat JS, Rafailidis V, Schrading S, Schreiber-Dietrich D, Dietrich CF. Ultrasound of the pleura in children, WFUMB review paper. Med Ultrason. 2021 Aug 11;23(3):339-347. doi: 10.11152/mu-3058. Epub 2021 Feb 1. PMID: 33626123.

Wernecke K. Ultrasound study of the pleura. Eur Radiol. 2000;10(10):1515-23. doi: 10.1007/s003300000526. PMID: 11044919.

Dietrich CF, Mathis G, Cui XW, Ignee A, Hocke M, Hirche TO. Ultrasound of the pleurae and lungs. Ultrasound Med Biol. 2015 Feb;41(2):351-65. doi: 10.1016/j.ultrasmedbio.2014.10.002. PMID: 25592455.

Dietrich CF, Hirche TO, Schreiber D, Wagner TO. Ultrasonography of Pleura and Lung [Sonographie von pleura und lunge]. Ultraschall Med. 2003 Oct;24(5):303-11. German. doi: 10.1055/s-2003-42912. PMID: 14562208.

Demi L, Wolfram F, Klersy C, De Silvestri A, Ferretti VV, Muller M, Miller D, Feletti F, Wełnicki M, Buda N, Skoczylas A, Pomiecko A, Damjanovic D, Olszewski R, Kirkpatrick AW, Breitkreutz R, Mathis G, Soldati G, Smargiassi A, Inchingolo R, Perrone T. New International Guidelines and Consensus on the Use of Lung Ultrasound. J Ultrasound Med. 2023 Feb;42(2):309-344. doi: 10.1002/jum.16088. Epub 2022 Aug 22. PMID: 35993596; PMCID: PMC10086956.

Abramowicz JS. Bioeffects and Safety of Lung Ultrasound in Neonates. J Ultrasound Med. 2022 Apr;41(4):1031. doi: 10.1002/jum.15772. Epub 2021 Jun 30. PMID: 34196023.

Miller DL, Abo A, Abramowicz JS, Bigelow TA, Dalecki D, Dickman E, Donlon J, Harris G, Nomura J. Diagnostic Ultrasound Safety Review for Point-of-Care Ultrasound Practitioners. J Ultrasound Med. 2020 Jun;39(6):1069-1084. doi: 10.1002/jum.15202. Epub 2019 Dec 23. PMID: 31868252.

Trovato GM, Sperandeo M. Usefulness of lung ultrasound imaging in COVID-19 pneumonia: The persisting need of safety and evidences. Echocardiography. 2020 Jul;37(7):1138-1139. doi: 10.1111/echo.14769. Epub 2020 Jun 23. PMID: 32574401; PMCID: PMC7362060.

Patterson B, Miller DL. Experimental Measurements of Ultrasound Attenuation in Human Chest Wall and Assessment of the Mechanical Index for Lung Ultrasound. Ultrasound Med Biol. 2020 Jun;46(6):1442-1454. doi: 10.1016/j.ultrasmedbio.2020.01.031. Epub 2020 Mar 24. PMID: 32217030; PMCID: PMC7185178.

Dietrich CF. Lung ultrasound for ever. Med Ultrason. 2022 Feb 16;24(1):5-6. doi: 10.11152/mu-3616. PMID: 35174814.

Wolfram F, Miller D, Demi L, Verma P, Moran CM, Walther M, Mathis G, Prosch H, Kollmann C, Jenderka KV. Best Practice Recommendations for the Safe use of Lung Ultrasound. Ultraschall Med. 2023 Oct;44(5):516-519. English. doi: 10.1055/a-1978-5575. Epub 2022 Nov 14. PMID: 36377189.

Jarman RD, McDermott C, Colclough A, Bøtker M, Knudsen L, Harris T, Albaroudi B, Albaroudi O, Haddad M, Darke R, Berry E, Breslin T, Fitzpatrick G, Flanagan L, Olusanya O, Craver D, Omar A, Simpson T, Cherian N, Dore M, Prosen G, Kay S, Villén-Villegas T, Gargani L, Carley S, Woo M, Dupriez F, Hussain A, Via G, Connolly JA, Peck M, Melniker L, Walden A, Attard Biancardi MA, Żmijewska-Kaczor O, Lalande E, Geukens P, McLaughlin R, Olszynski P, Hoffmann B, Chin E, Muhr C, Kim DJ, Mercieca A, Shukla D, Hayward S, Smith M, Gaspari R, Smallwood N, Pes P, Tavazzi G, Corradi F, Lambert M, Morris C, Trauer M, Baker K, Bystrzycki A, Goudie A, Liu R, Rudd L, Dietrich CF, Jenssen C, Sidhu PS. EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) LONG VERSION. Ultraschall Med. 2023 Feb;44(1):e1-e24. English. doi: 10.1055/a-1882-5615. Epub 2022 Oct 13. PMID: 36228631.

Mathis G, Horn R, Morf S, Prosch H, Rovida S, Soldati G, Hoffmann B, Blaivas M, Dietrich CF. WFUMB position paper on reverberation artefacts in lung ultrasound: B-lines or comet-tails? Med Ultrason. 2021 Feb 18;23(1):70-73. doi: 10.11152/mu-2944. PMID: 33621275.

Fang C, Jaworska J, Buda N, Ciuca IM, Dong Y, Feldkamp A, Jüngert J, Kosiak W, Mentzel HJ, Pienar C, Rabat JS, Rafailidis V, Schrading S, Schreiber-Dietrich D, Dietrich CF. Ultrasound of the chest and mediastinum in children, interventions and artefacts. WFUMB review paper (part 3). Med Ultrason. 2022 Feb 16;24(1):65-67. doi: 10.11152/mu-3323. Epub 2021 Jun 23. PMID: 34216456.

Picano E, Scali MC, Ciampi Q, Lichtenstein D. Lung Ultrasound for the Cardiologist. JACC Cardiovasc Imaging. 2018 Nov;11(11):1692-1705. doi: 10.1016/j.jcmg.2018.06.023. PMID: 30409330.

Fentress M, Ezibon P, Bulabek A, Schwanfelder C, Schrift D, Shah S, Tsung J, Nadimpalli A. A Lung Ultrasound Scanning Technique for Children and Adults in Low-Resource Settings: Preliminary Experiences in Sub-Saharan Africa. Am J Trop Med Hyg. 2021 Sep 27;105(5):1148-1151. doi: 10.4269/ajtmh.20-0272. PMID: 34583341; PMCID: PMC8592227.

Brogi E, Gargani L, Bignami E, Barbariol F, Marra A, Forfori F, Vetrugno L. Thoracic ultrasound for pleural effusion in the intensive care unit: a narrative review from diagnosis to treatment. Crit Care. 2017 Dec 28;21(1):325. doi: 10.1186/s13054-017-1897-5. PMID: 29282107; PMCID: PMC5745967.

Fayssoil A, Behin A, Ogna A, Mompoint D, Amthor H, Clair B, Laforet P, Mansart A, Prigent H, Orlikowski D, Stojkovic T, Vinit S, Carlier R, Eymard B, Lofaso F, Annane D. Diaphragm: Pathophysiology and Ultrasound Imaging in Neuromuscular Disorders. J Neuromuscul Dis. 2018;5(1):1-10. doi: 10.3233/JND-170276. PMID: 29278898; PMCID: PMC5836400.

Le Neindre A, Philippart F, Luperto M, Wormser J, Morel-Sapene J, Aho SL, Mongodi S, Mojoli F, Bouhemad B. Diagnostic accuracy of diaphragm ultrasound to predict weaning outcome: A systematic review and meta-analysis. Int J Nurs Stud. 2021 May;117:103890. doi: 10.1016/j.ijnurstu.2021.103890. Epub 2021 Jan 29. PMID: 33588324.

Vetrugno L, Guadagnin GM, Barbariol F, Langiano N, Zangrillo A, Bove T. Ultrasound Imaging for Diaphragm Dysfunction: A Narrative Literature Review. J Cardiothorac Vasc Anesth. 2019 Sep;33(9):2525-2536. doi: 10.1053/j.jvca.2019.01.003. Epub 2019 Jan 4. PMID: 30686657.

Nekludova GV, Avdeev SN. Possibilities of ultrasound research of the diaphragm. Ter Arkh. 2019 Mar 30;91(3):86-92. doi: 10.26442/00403660.2019.03.000129. PMID: 31094465.

Haaksma ME, Smit JM, Boussuges A, Demoule A, Dres M, Ferrari G, Formenti P, Goligher EC, Heunks L, Lim EHT, Mokkink LB, Soilemezi E, Shi Z, Umbrello M, Vetrugno L, Vivier E, Xu L, Zambon M, Tuinman PR. EXpert consensus On Diaphragm UltraSonography in the critically ill (EXODUS): a Delphi consensus statement on the measurement of diaphragm ultrasound-derived parameters in a critical care setting. Crit Care. 2022 Apr 8;26(1):99. doi: 10.1186/s13054-022-03975-5. PMID: 35395861; PMCID: PMC8991486.

Vetrugno L, Corvino A, Maggiore SM. Ultrasound of the diaphragm: Competency ≠ patients outcome. J Clin Ultrasound. 2022 Feb;50(2):263-264. doi: 10.1002/jcu.23131. PMID: 35148002.

Pietersen PI, Madsen KR, Graumann O, Konge L, Nielsen BU, Laursen CB. Lung ultrasound training: a systematic review of published literature in clinical lung ultrasound training. Crit Ultrasound J. 2018 Sep 3;10(1):23. doi: 10.1186/s13089-018-0103-6. PMID: 30175392; PMCID: PMC6119680.

Mozzini C, Fratta Pasini AM, Garbin U, Cominacini L. Lung ultrasound in internal medicine: training and clinical practice. Crit Ultrasound J. 2016 Dec;8(1):10. doi: 10.1186/s13089-016-0048-6. Epub 2016 Aug 8. PMID: 27501700; PMCID: PMC4977240.

Nathanson R, Le MT, Proud KC, LoPresti CM, Haro EK, Mader MJ, O'Rorke J, Wathen PI, Soni NJ. Development of a Point-of-Care Ultrasound Track for Internal Medicine Residents. J Gen Intern Med. 2022 Jul;37(9):2308-2313. doi: 10.1007/s11606-022-07505-5. Epub 2022 Jun 17. PMID: 35713808; PMCID: PMC9205286.

Kurepa D, Zaghloul N, Watkins L, Liu J. Neonatal lung ultrasound exam guidelines. J Perinatol. 2018 Jan;38(1):11-22. doi: 10.1038/jp.2017.140. Epub 2017 Nov 16. PMID: 29144490.

Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, Melniker L, Gargani L, Noble VE, Via G, Dean A, Tsung JW, Soldati G, Copetti R, Bouhemad B, Reissig A, Agricola E, Rouby JJ, Arbelot C, Liteplo A, Sargsyan A, Silva F, Hoppmann R, Breitkreutz R, Seibel A, Neri L, Storti E, Petrovic T; International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012 Apr;38(4):577-91. doi: 10.1007/s00134-012-2513-4. Epub 2012 Mar 6. PMID: 22392031.

Duggan NM, Shokoohi H, Liteplo AS, Huang C, Goldsmith AJ. Best Practice Recommendations for Point-of-Care Lung Ultrasound in Patients with Suspected COVID-19. J Emerg Med. 2020 Oct;59(4):515-520. doi: 10.1016/j.jemermed.2020.06.033. Epub 2020 Jun 12. PMID: 32713618; PMCID: PMC7290164.

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Published
2025-09-15
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Rafał Rajski, Dominik Tenczyński, Michał Kostro, Anna Żurakowska-Zadrożna, Wiktor Warda, Agata Wysocka, Patrycja Trentkiewicz, & Jarosław Jarosławski. (2025). LUNG ULTRASOUND: CONTEMPORARY POSSIBILITIES - ORIGINAL PAPER. International Journal of Innovative Technologies in Social Science, 3(3(47). https://doi.org/10.31435/ijitss.3(47).2025.3768

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