Vertical displacement of pleura: a new method for bronchospasm evaluation?

Vertical displacement of pleura: a new method for bronchospasm evaluation?

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Abstract Background Lung ultrasonography has been increasingly recognized has a valuable diagnostic tool.In adult patients with asthma/chronic obstructive pulmonary disease and wheezing, LUS usually presents as an A/nude profile (normal profile, with sliding and A-lines, and without any abnormal findings) or at most reveals a decrease/absence of lung sliding.Therefore, until now Ball - Coach Aids simple point-of-care ultrasonography appeared to be unable to assess the severity of airflow limitation.

Case presentation We report the case of a woman presenting to the emergency department with an asthma exacerbation.Bedside ultrasound showed the usual A/normal profile, but also an associated vertical pleural displacement, probably secondary to hyperinflation and accessory muscle recruitment.We evaluated the described movement with M-mode and established a comparison index between end-inspiration and end-expiration, using the skin as reference.

This index showed improvement and complete normalization during treatment.Conclusions Pleural vertical displacement appears to be a sonographic alteration Other associated to bronchospasm and accessory muscle recruitment.It is easily identifiable and measurable on LUS, thus possibly representing a new method to evaluate bronchospasm and monitoring treatment response.

Further research is needed to confirm or refute this finding.