• Federico Bilotta, Luigi D Giudici, Ivan O Zeppa, Carolina Guerra, Elisabetta Stazi, and Giovanni Rosa.
• Section of Neuroanesthesia and Neurocritical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University of Rome, Rome, Italy. bilotta@tiscali.it
• Eur J Anaesthesiol. 2013 Aug 1;30(8):464-8.

ContextLung ultrasound imaging can be used to evaluate pulmonary water content and pulmonary consolidation in ICU patients, but data from neurocritical care are lacking.ObjectiveTo evaluate the utility of lung ultrasound to estimate the PaO2/FiO2 ratio and its diagnostic accuracy compared with chest radiograph and thoracic computed tomography (CT).DesignProspective, observational study.SettingUniversity hospital neurocritical care unit.PatientsForty-five consecutive patients.Main Outcome MeasuresThe relationship between the number of B-lines and the PaO2/FiO2 ratio as measure of lung water content, and the diagnosis of pulmonary consolidation.ResultsEvaluation of lung water content as determined by the number of 'B-lines' has a linear relationship with the PaO2/FiO2 ratio (r = -0.8; P < 0.01). Lung ultrasound has a diagnostic accuracy similar to that of chest radiograph (99 vs. 96%), using thoracic CT as the reference technique.ConclusionIn neurocritical care, the use of lung ultrasound allows detection of increased lung water content when more than three 'B-lines' are present within the same lung field. This is associated with a reduction in PaO2/FiO2 ratio. Lung ultrasound can be used to diagnose pulmonary consolidation with an accuracy similar to the chest radiograph.

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