Lung ultrasound (LUS) has significantly evolved over the past 30 years, becoming an essential tool in intensive care units (ICUs) for managing critically ill patients with respiratory failure. Traditionally, computed tomography (CT) was considered the gold standard for thoracic imaging. However, its limitations—such as patient transportation challenges and ionizing radiation exposure—make it unsuitable for real-time bedside decision-making. Chest X-ray and lung ultrasound have emerged as viable alternatives. While chest X-ray remains a key diagnostic tool, lung ultrasound has gained recognition for its dynamic, real-time diagnostic capabilities, making it particularly valuable in adjusting mechanical ventilation, fluid therapy, patient positioning, and other interventions.
The significance of LUS
The significance of LUS was further amplified during the COVID-19 pandemic, where it became pivotal in managing patients with severe respiratory distress. This review tracks the major milestones in LUS development, starting with its use in detecting lung sliding, lung point, and comet-tail artifacts. Daniel Lichtenstein’s pioneering work from the 1990s laid the foundation for modern ICU ultrasound practices. His discoveries, including signs such as lung pulse and dynamic air bronchogram, have drastically improved the diagnostic accuracy of LUS. These advancements are now part of ICU protocols, helping identify conditions like pneumothorax, atelectasis, and interstitial syndromes.As LUS continues to evolve, its role in real-time management and decision-making in ICU settings will likely expand, leading to better outcomes in critically ill patients.
This review highlights key advancements and protocols for LUS use in the ICU, offering insights into its future potential in clinical practice.
