Lung Ultrasound in ARDS: The Pink-Protocol. The Place of Some Other Applications in the Intensive Care Unit (CLOT-Protocol, Fever-Protocol)

  • Daniel A. Lichtenstein


Some critically ill patients with massive loss of lung function are not dyspneic, not blue, and have a quiet breathing, just because they are deeply sedated and curarized on occasion and receive pure oxygen. This is mainly the case of ARDS. Lung ultrasound in these patients does not strictly obey to the rules of the BLUE-protocol. This setting was called the Pink-protocol. Not surprisingly in our discipline, the definitions of ARDS changed recently. A homogeneous management is en route, but not fully achieved, with space for discussion [1, 2]. It is peculiar to see that, even if lung ultrasound was of possible use when ARDS was defined [3], in the 2012 definition, lung ultrasound was still not fully, deeply integrated (Anecdotical Note 1). Time will correct this. We assume that LUCI will clarify more than confuse, helping in better classifying this multifaceted disease. The lung is a complex organ, and such an injury (ARDS) can complexify the field even more [4, 5]. Hopingly, an intensive use of ultrasound (lung, veins, diaphragm, heart, etc.) may optimize patient’s survival or quicker discharge from the ICU.


Lung Ultrasound Maxillary Sinusitis Common Femoral Vein Quiet Breathing Pleural Line 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 28.1

Jugular internal floating thrombosis. In this jugular internal vein, this 1982 technology, associated with a low-quality digitalization, shows however a floating thrombosis with systolodiastolic halting movements: the mass is obviously attracted by the right auricular diastole. One guesses the severity of these findings. The small footprint probe of this ADR-4000 was inserted on the supraclavicular fossa, allowing to see the Pirogoff confluence. (MOV 5043 kb)


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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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