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The Role of Ultrasound (US) in Thoracic Surgery

  • Stefaan Bouchez
  • Patrick F. WoutersEmail author
Chapter

Abstract

This chapter will focus on the use of ultrasound-based imaging techniques to monitor cardiorespiratory function and anatomy in patients undergoing thoracic surgery. The two primary applications discussed are echocardiography and lung ultrasound, both of which offer specific advantages over traditional perioperative monitoring tools.

Echocardiography is of special interest in thoracic anesthesia for its unique ability to monitor right ventricular function. In selected patients at risk for the development of right ventricular dysfunction, associated with lung disease or as a result of the surgical procedure, the use of intraoperative transesophageal echocardiography may assist in mitigating RV failure.

The diagnostic power of lung ultrasound has long been questioned as air is a strong reflector. However, pioneers in the field have shown that artefacts created by the interplay between lung tissue and ultrasound waves provide clinically relevant information about pulmonary and pleural function, and that specific lung disease states can be diagnosed through pattern recognition. In fact, lung ultrasound when used in combination with echocardiography offers incremental value in the perioperative assessment of patients undergoing thoracic surgery.

It is not yet clear whether the perioperative use of these techniques will affect surgical outcome. At present, there is a large practice variability with regard to the use of ultrasound in routine practice which appears to depend primarily on the individual anesthesiologist’s knowledge and experience with the technology. The growing interest has created a large need for training in the anesthesia community. Ideally, ultrasound training should be integrated in the basic curriculum of every anesthesiologists. In particular, anesthesiologists involved in the perioperative care of patients undergoing thoracic surgery should be encouraged to acquire the skills and knowledge necessary to perform a standardized basic echocardiography and lung ultrasound exam.

Keywords

Ultrasound Echocardiography Lung ultrasonography Thoracic anesthesia Thoracic surgery Hemodynamic monitoring Cardiac function Right ventricle Perioperative care 

Supplementary material

Video 17.1

Lung sliding 1 (M4V 236 kb)

Video 17.2

Lung pulse (M4V 234 kb)

Video 17.3

Lung point 1 (M4V 247 kb)

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Anesthesia and Perioperative Medicine, Ghent University HospitalGhent UniversityGhentBelgium

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