BLUE（bedside lung ultrasound in emergency ） protocol

概念
観察部位
診るべき4つのポイント

概念

・急性呼吸不全や低酸素血症の原因検索を迅速に行うための、ベッドサイドでの超音波検査法

・胸郭の上方と下方で、それぞれ前方、側方、後側方の6点から肺を観察する。

・肺炎に対して感度88％、特異度90％、心原生肺水腫に対して感度86％、特異度87％

観察部位

・胸郭の上方と下方で、それぞれ前方、側方、後側方の片肺計6点、両肺計12点から肺を観察する。

参照（このサイトより引用）：https://ccforum.biomedcentral.com/articles/10.1186/s13054-021-03759-3

‘Bedside Lung Ultrasound in Emergency’ (BLUE) and 12-zone lung ultrasound protocol.

The blue points represent BLUE-points of the lung ultrasound protocol, they are identified as follows: two hands are placed consecutively just below the clavicle, excluding the thumbs. The upper BLUE-point is at the middle of the upper hand, whereas the Lower BLUE-point is at the middle of the lower palm. The posterolateral alveolar and/or pleural syndrome (PLAPS)-point is just below the posterior axillary line at the height of the diaphragm.

At the PLAPS-point the probe was moved posteriorly in order to obtain as much information as possible about the posterior lung region.

The green points are scanned additionally in the 12-zone lung ultrasound protocol. AAL: anterior axillary line; PAL: posterior axillary line; B1: BLUE-1; B2: BLUE-2; LS: lateral superior; LI: lateral inferior; PS: posterior superior; PLAPS: posterolateral alveolar and/or pleural syndrome.

b A schematic image of how thoracic CT was divided into two hemithoraces and an anterior and posterior region. Two lines were drawn tangent to the anterior and posterior border of both lungs and at the height of the sternum anteriorly and spinous process posteriorly a line perpendicular to the tangent lines was drawn to divide the thoracic cavity into a right and left side.

Both lungs were then divided into an anterior and posterior half by drawing a line perpendicular from the middle of the line between the sternum and spinous process to the lateral border of the lung. Each hemithorax was evaluated for anterior consolidations, posterior consolidations, interstitial syndrome, pneumothorax or pleural effusion