Interstitial Syndrome and the BLUE-Protocol: The B-Line

  • Daniel A. Lichtenstein


Nothing is banal with lung ultrasound in the critically ill. It requires the simplest machines, one ideal probe also suitable for the whole body, and only two signs for mastering the normal pattern of this organ which is the most voluminous and the most vital one. This is the paradox of lung ultrasound, again.


Fluid Element Lung Ultrasound Visceral Pleura Lung Surface Interlobular Septum 
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Supplementary material

Video 11.1

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  1. 1.
    Friedman PJ (1992) Diagnostic tests in respiratory diseases. In: Harrison TR (ed) Harrison’s principles of internal medicine, 12th edn. McGraw-Hill, New York, p 104Google Scholar
  2. 2.
    Weinberger SE, Drazen JM (2001) Diagnostic tests in respiratory diseases. In: Harrison TR (ed) Harrison’s principles of internal medicine, 14th edn. McGraw-Hill, New York, pp 1453–1456Google Scholar
  3. 3.
    Lichtenstein D (1994) Diagnostic échographique de l’œdème pulmonaire. Rev Im Med 6:561–562Google Scholar
  4. 4.
    Lichtenstein D, Mezière G, Biderman P, Gepner A, Barré O (1997) The comet-tail artifact: an ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 156:1640–1646CrossRefPubMedGoogle Scholar
  5. 5.
    Laënnec RTH (1819) Traité de l’auscultation médiate, ou traité du diagnostic des maladies des poumons et du cœur. J.A. Brosson & J.S. Chaudé, ParisGoogle Scholar
  6. 6.
    Williams FH (1986) A method for more fully determining the outline of the heart by means of the fluoroscope together with other uses of this instrument in medicine. Boston Med Surg J 135:335–337CrossRefGoogle Scholar
  7. 7.
    Fraser RG, Paré JA (1988) Diagnoses of disease of the chest, 3rd edn. WB Saunders Company, PhiladelphiaGoogle Scholar
  8. 8.
    Hounsfield GN (1973) Computerized transverse axial scanning. Br J Radiol 46:1016–1022CrossRefPubMedGoogle Scholar
  9. 9.
    Ziskin MC, Thickman DI, Goldenberg NJ, Lapayowker MS, Becker JM (1982) The comet-tail artifact. J Ultrasound Med 1:1–7CrossRefPubMedGoogle Scholar
  10. 10.
    Volpicelli G, Caramello V, Cardinale L et al (2008) Bedside ultrasound of the lung for the monitoring of acute decompensated heart failure. Am J Emerg Med 26:585–591CrossRefPubMedGoogle Scholar
  11. 11.
    Lichtenstein D, Mezière G, Biderman P, Gepner A (1999) The comet-tail artifact, an ultrasound sign ruling out pneumothorax. Intensive Care Med 25:383–388CrossRefPubMedGoogle Scholar
  12. 12.
    Lichtenstein D, Mezière G, Lascols N, Biderman P, Courret JP, Gepner A, Goldstein I, Tenoudji-Cohen M (2005) Ultrasound diagnosis of occult pneumothorax. Crit Care Med 33:1231–1238CrossRefPubMedGoogle Scholar
  13. 13.
    Lichtenstein D (2014) Lung ultrasound in the critically ill. Ann Intensive Care 4(1):1–12CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Daniel A. Lichtenstein
    • 1
  1. 1.Hôpital Ambroise Paré Service de Réanimation MédicaleBoulogne (Paris-West University)France

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