Role of pulmonary ultrasound in the diagnosis of acute respiratory failure

Dyspnea is the main clinical manifestation of acute respiratory failure; however, it can be induced by different causes that require differential diagnosis. In elderly patients, the medical examination is limited by cognitive and physical deficits and the genesis of dyspnea is often multifactorial; therefore, the definition of the causes is more complex. In recent years, among the various diagnostic methods, pulmonary ultrasonography has found increasing interest and the main patterns of ultrasound semeiotics have been described, specially in the emergency and critical care setting, as for pneumonia, pleural effusion, pneumothorax, pulmonary infarction, interstitial pathology. The most recent Literature emphasizes the role of multi-organ ultrasound (pleuro-pulmonar; cardiac; caval and iliac-femoral venous), to diagnose with good accuracy the causes of dyspnea. In this review we report the lung ultrasound semeiotic patterns, useful for the bedside or pointof- care detection of the cause of dyspnea, particularly respiratory and/or cardiac, during the medical examination.