Newly Published
Images in Anesthesiology  |   June 2019
Intraoperative Application of Lung Ultrasound to Diagnose Alveolar Consolidation
Author Notes
  • From the Department of Anesthesia, Emory University, Atlanta, Georgia.
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Correspondence: Address correspondence to Dr. Hollon: mmayo2@emory.edu
Article Information
Images in Anesthesiology / Radiological and Other Imaging / Respiratory System
Images in Anesthesiology   |   June 2019
Intraoperative Application of Lung Ultrasound to Diagnose Alveolar Consolidation
Anesthesiology Newly Published on June 4, 2019. doi:10.1097/ALN.0000000000002761
Anesthesiology Newly Published on June 4, 2019. doi:10.1097/ALN.0000000000002761
Lung ultrasound is a valuable diagnostic tool in identifying pulmonary pathology. This image demonstrates ultrasonographic evidence of alveolar consolidation and atelectasis in a patient with intraoperative hypoxemia. In this transesophageal echocardiographic image, the descending thoracic aorta (A) appears at the top of the scanned sector and the left chest cavity beyond it. Within the chest cavity, an anechoic pleural effusion (F) is present, and the lung (L) is noted to have a liver tissue-like appearance with presence of air bronchograms (arrows). Two different types of air bronchograms, dynamic and static, are seen in the video (Supplemental Digital Content, http://links.lww.com/ALN/B947). Dynamic air-bronchograms are highly specific ultrasonographic signs of pneumonia as the cause of consolidation.1,2  On ultrasound imagining, they are seen as hyperechoic opacities that move with the respiratory cycle. These hyperechoic opacities are generated as a result of higher acoustic reflectance of the aerated bronchi compared with the surrounding consolidated lung. Lung hepatization is also seen in the image as the collapsed alveoli assume tissue-like density resembling liver. The movement of air bronchograms with respiration distinguishes nonretractable consolidation from resorptive atelectasis.1  As resorptive atelectasis occurs as a result of airway obstruction, on ultrasound evaluation the trapped, isolated air results in generation of static air bronchograms (Supplemental Digital Content, http://links.lww.com/ALN/B947).