Abstract:
INTRODUCTION:We conducted an ultrasound study to investigate echocardiographic artifacts in mechanically ventilated patients with lung pathology. METHODS:A total of 205 mechanically ventilated patients who exhibited lung atelectasis and/or pleural effusion were included in this 36-month study. The patients underwent lung echography and transthoracic echocardiography, with a linear 5 to 10 MHz and with a 1.5 to 3.6 MHz wide-angle phased-array transducer, respectively. Patients were examined by two experienced observers who were blinded to each other's interpretation. RESULTS:A total of 124 patients (60,48%) were hospitalized because of multiple trauma; 60 patients (29,26%) because of respiratory insufficiency, and 21 (10,24%) because of recent postoperative surgery. The mean duration ( +/- standard deviation) of hospitalization was 35 +/- 27 days. An intracardiac artifact was documented in 17 out of 205 patients (8.29%) by echocardiography. It was visible only in the apical views, whereas subsequent transesophageal echocardiography revealed no abnormalities. The artifact consisted of a mobile component that exhibited, on M-mode, a pattern of respiratory variation similar to the lung 'sinusoid sign'. Lung echography revealed lung atelectasis and/or pleural effusion adjacent to the heart, and a similar M-mode pattern was observed. The artifact was recorded within the left cardiac chambers in 11 cases and within the right cardiac chambers in six. CONCLUSIONS:Lung atelectasis and/or pleural effusion may create a mirror image, intracardiac artifact in mechanically ventilated patients. The latter was named the 'cardiac-lung mass' artifact to underline the important diagnostic role of both echocardiography and lung echography in these patients. TRIAL REGISTRATION:This trial is ISRCTN registered: ISRCTN 49216096.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Karabinis A,Saranteas T,Karakitsos D,Lichtenstein D,Poularas J,Yang C,Stefanadis Cdoi
10.1186/cc7021subject
Has Abstractpub_date
2008-01-01 00:00:00pages
R122issue
5eissn
1364-8535issn
1466-609Xpii
cc7021journal_volume
12pub_type
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