Review Article

Chest Ultrasonography in Modern Day Extreme Settings: From Military Setting and Natural Disasters to Space Flights and Extreme Sports

Table 2

Conditions for which the use of CU has been proposed in the scientific literature.

Interesting contribution to diagnosisUltrasonographic methodSignsTreatment

Pericardial effusion [28]Direct visualizationHypoanechoic layer posterior to the heartMonitoring
Pericardial tamponade [17]Repeated assessment of pericardial effusion50% IVC change in diameter during inspiration (sensitive/nonspecific)/RA collapse that exceeds one-third of cardiac cycle is nearly 100% sensitive and specific/RV diastolic collapse (nonsensitive)/inspiratory septal shift is not specificUltrasound-guided long-needle periocardiocentesis
Intravascular volume depletion estimation [40]Measurement of the diameter of the IVC just below the diaphragmcIVC (IVCmax − IVCmin)/IVCmax >42%Follow-up after fluid administration
PE [36, 41]Assessment of lung sonographic artifactsPresence of B-line artifacts: absence of A-line artifactsMonitoring
Pneumothorax [34]Lung sliding detectionAbsence of lung sliding and lung pointsTo guide decompression of the correct pleural space
Pleural effusion [25]Direct visualizationHypoanechoic layer of polygonal area under the pleural lineChest tube placement and verification
Pulmonary contusion [25]Direct visualizationLung hepatization: B-lines and shred signMonitoring
Soft tissue infection of the chest wall [18]Direct visualizationCellulitis has cobblestone appearance/abscesses are complex structuresGuide planning for the best location for incision and drainage
Bony thoracic cage fracturesDirect visualization of the fracture and evaluation of complications (e.g., pneumothorax, pleural effusion, lung contusion, and hematoma of the chest wall)Chimney phenomenon, interruption of cortical bone, and soft tissue hematoma

IVC: inferior vena cava; RV: right ventricle; RA: right atrium; cIVC: inferior vena cava collapsibility index; IVCmax: inferior vena cava maximum diameter; IVCmin: inferior vena cava minimum diameter; PE: pulmonary edema.