Περίληψη:
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.
Συγγραφείς:
Karabinis, Andreas
Saranteas, Theodosios
Karakitsos, Dimitrios
and Lichtenstein, Daniel
Poularas, John
Yang, Clifford and
Stefanadis, Christodoulos
