(1)
Hôpital Ambroise Paré Service de Réanimation Médicale, Boulogne (Paris-West University), France
Here most of the technical words coined or used for the BLUE-protocol and LUCI are featured. The artifacts, benefiting from Chap. 40, are just listed.
A/B-profile (BLUE-protocol)
Predominance of A-lines at one lung and of B-lines at the other, in Stage 1.
Anechoic
Free of echo. The tone is black by convention.
A-predominance (FALLS-protocol)
Detection of either an A-profile, A’-profile, or A/B-profile.
A-profile (BLUE-protocol)
Association of predominant A-lines and lung sliding in Stage 1.
A’-profile (BLUE-protocol)
Association of predominant A-lines and abolished lung sliding in Stage 1.
A-DVT profile (BLUE-protocol)
Association of an A-profile with a deep venous thrombosis. Association quite specific to pulmonary embolism.
A-no-V-PLAPS-profile (BLUE-protocol)
The longest label. Association of an A-profile with an absence of deep venous thrombosis and the presence of a PLAPS.
Artifact
Artificial image created by the physical principles of propagation of the ultrasound beams. The shape is always geometrical with precise symmetrical axes. Artifacts do not correspond to real anatomical structures.
Avicenne’s sign
In the case of a pneumothorax (generating absence of movement) in a dyspneic patient (generating muscular movements), the use of M-mode allows to detect the standstillness of the pleural line through the dynamic of the muscular recruitment. When the column of sand which appears above the pleural line crosses the pleural line and remains fully unchanged, this demonstrates that lung sliding is definitely abolished. This is the Avicenne’s sign.
Bat sign
In the initial and basic step of any lung ultrasound, the bat sign identifies in a longitudinal view the upper and lower ribs (the wings) and, deeper, the pleural line (the belly of the bat). This step makes it possible to correctly locate the pulmonary structures in any conditions.
Bat wing sign
Special pattern displayed by a peritoneal effusion, surrounded by convex limits. This sign is of interest for detecting non-anechoic effusions (i.e., the most severe cases).
Bed level (at)
When the probe explores the lateral chest wall in a supine patient and cannot explore more posterior (without moving the patient) because of the bed, the probe is said to be applied at bed level (or FDL). If pleural effusion is visible at bed level, this means that this effusion has substantial volume.
BLUE-hands
Two hands applied on the thorax, one above another, thumbs excepted, beginning just below the clavicle immediately show the lung location (the lowest finger being usually at the chest/abdomen junction. The term “BLUE”-hands means that the hands are those, theoretically, of the patient (from any size, any age).
BLUE-consolidation index, BLUE-pleural index
Approximate way to rapidly and simply estimate the volume of a lung consolidation or a pleural effusion (Chap. 28). A standardized area of measurement in a standardized position of the patient (supine, slightly turned to the opposed way), a standardized location (the PLAPS-point), and a standardized probe (a microconvex probe that can be inserted far to the posterior wall). The expiratory distance between pleural line and lung line roughly correlate with the abundance of the effusion.
BLUE-protocol
This is a fast protocol for diagnosis of the cause in acutely blue patients. It associates bedside lung ultrasound in an emergency and a venous scanning adapted to the critically ill. The BLUE-protocol proposes simple profiles helping in assessing the cause of an acute respiratory failure.
BLUE-points
Standardized locations immediately accessible and allowing immediate diagnosis of the main life-threatening disorders. In the BLUE-protocol, two anterior points and one subposterior point are used.
B-predominance (FALLS-protocol)
Detection of either a B-profile or a B’-profile.
Carmen maneuver
This basic probe movement makes critical ultrasound easier. The probe is applied on the skin, without excessive pressure. It is gently shifted like a large paintbrush, i.e., to the left then right when the probe is in a longitudinal position or to the top then to the bottom in a transversal position, taking advantage of the gliding of the skin over the underskin, i.e., staying at the same position. It allows to control the three dimensions: in a longitudinal scan, it shows lateral images, i.e., scans transversally, without losing the target.
B-profile (BLUE-protocol)
Association of predominant lung rockets and lung sliding in Stage 1.
B’-profile (BLUE-protocol)
Association of predominant lung rockets and abolished lung sliding in Stage 1.
C-profile (BLUE-protocol)
Detection of alveolar syndrome in Stage 1 (anterior chest wall, supine patient, Earth level).
CLOT-protocol
(Catheter-Linked Occult Thromboses protocol) Daily analysis of the venous areas which have received cannulation in long-staying patients, performed routinely and after any acute worsening. By making early detection and follow-up of the deep venous thromboses, it allows to help in the diagnosis of pulmonary embolism in these challenging patients.
Comet-tail artifact
This term designates a repetition artifact which is hyperechoic and roughly vertical. It can arise or not from the pleural line. It can move in concert with the pleural line or not. It can be long or not. It can be well defined or not. It can erase other underlying structures or not. It can be hyperechoic like the pleural line or not. Many comet-tail artifacts can be described, the B-line (for interstitial syndrome) being one of them.
Consolidation index
Simple measurement of an alveolar consolidation using an area at a given point and assuming that the consolidation has roughly three similar dimensions.
Culminating (sign, point)
This term refers to the sky-Earth axis and indicates something near the sky.
Dark lung (ultrasound dark lung)
A situation where a diffusely hypoechoic pattern is recorded at the chest wall, with no static or dynamic element that can affirm a solid or fluid predominance. The radiograph usually shows a white lung.
Dependent (sign, point)
This term refers to the sky-Earth axis and indicates something near the Earth.
DIAFORA approach
This term describes the use of Doppler when necessary, using an outside machine and an outside operator and, if necessary, transporting the patient (as done for the CT examinations). DIAFORA means Doppler Intermittently Asked From Outside in Rare Applications. It allows the physician to, meanwhile, rapidly benefit from a cost-effective machine which will be of daily help. The concept is based on the rarity of these situations and based also on the degree of emergency, which usually allows to wait open hours.