[Lung Ultrasonography in Intensive Care Medicine]

Lung Ultrasound (LUS) has emerged in recent years as an extremely valuable diagnostic and monitoring tool, and as an increasingly standardized procedure in intensive care medicine. It provides rapid, radiation-free, bedside (POCUS: point-of-care ultrasound) diagnostics for thoracic diseases. Pathological Findings: LUS enables the detection of pathological lung findings such as pleural effusion, pneumothorax, consolidations including atelectasis and pneumonic infiltrates, as well as interstitial syndromes in the context of ARDS. In cases presenting with the key symptom of dyspnea, LUS helps to differentiate between cardiac, pulmonary, and combined causes (BLUE protocol). Scoring systems - e.g., the Lung Ultrasound Score (LUSS) - quantify the severity and course of lung changes in pneumonia or ARDS and support therapeutic decision-making. LUS can thus be used in critically ill patients to assess the effectiveness of ventilation strategies and to monitor the progression of respiratory failure. Interventions and Weaning: LUS is also an important tool in thoracic interventions such as punctures or drain placements, as it increases safety and precision. In the weaning process of invasively ventilated patients, ultrasound provides valuable information, for example on lung aeration and the risk of weaning failure. Sonographic access to the lung is limited to intercostal spaces; however, approximately 70% of the pleural surface is accessible. Central lung processes, particularly in ventilated lungs without consolidations, cannot be visualized sonographically.