Analyses of Lung Parenchyma Infiltrates Using Ultrasonography in Neurocritically ill Patients

Area of Science:

• Neurology
• Pulmonology
• Radiology

Background:

• Pulmonary complications frequently occur in patients with severe brain injuries.
• Early detection and characterization of lung infiltrates are crucial for patient management.

Purpose of the Study:

• To assess the prevalence of pulmonary infiltrates on admission in patients with intracranial hemorrhages (ICH and SAH).
• To determine the etiology of these infiltrates and evaluate the agreement between lung ultrasonography and chest radiography.

Main Methods:

• Prospective analysis of 44 patients (30 ICH, 14 SAH) over 3 months.
• Standardized lung ultrasonography protocol and collection of clinical/ancillary data.
• Comparison of findings with chest radiography.

Main Results:

• Lung B-lines were detected in 73.3% of ICH patients and 57.14% of SAH patients.
• Neurogenic pulmonary edema was suspected in 43% of ICH and 7.1% of SAH cases.
• Cardiogenic pulmonary edema was suspected in 13% of ICH and 28.5% of SAH cases; agreement between imaging modalities was poor.

Conclusions:

• Sonographic lung infiltrates are prevalent in patients with severe brain injuries, affecting up to two-thirds of ICH admissions and the majority of SAH cases.
• Etiologies vary, with neurogenic pulmonary edema more common in ICH and cardiogenic pulmonary edema in SAH.
• Lung ultrasonography is a useful tool for detecting infiltrates, but agreement with chest radiography is limited.