Skip to main content
  • Poster presentation
  • Published:

Lung ultrasound in quantifying lung water in septic shock patients


Quantification of lung ultrasound (LUS) artifacts (B-lines) is used to assess pulmonary congestion in emergency medicine and cardiology [1, 2]. We investigated B-lines in relation to extravascular lung-water index (EVLWI) from invasive transpulmonary thermodilution in septic shock patients. Our aim was to evaluate the role of LUS in an intensive care setting.


Twenty-one patients admitted with septic shock to a general ICU underwent LUS of eight zones, four per hemithorax, within 24 hours after ICU admission. EVLWI was calculated simultaneously by transpulmonary thermodilution using a pulse-contour continuous cardiac output system, and NT-proBNP and clinical data were collected. Two physicians blinded to other data independently quantified the number of B-lines. Spearman's rho was used to test the correlation of B-lines to EVLWI and clinical data, and linear regression and Bland- Altman analysis were used to assess the agreement between B-lines and EVLWI. Interobserver variability was tested using Bland-Altman analysis and intraclass correlation coefficient (ICC).


Fourteen patients (67%) were male, the median age was 62 years (IQR 55 to 68) and eight (38%) patients had cardiac comorbidities. In median, SAPS 3 was 64 (IQR 60 to 74), ICU length of stay was 3 days (IQR 2 to 8) and seven patients (33%) died within 30 days of ICU admission. All patients were mechanically ventilated and treated according to guidelines [3]. The median number of B-lines was 15 (IQR 10 to 30) and the median (IQR) NT-proBNP, EVLWI and oxygenation index (OI) were 7,800 ng/l (3,690 to 15,050), 11 ml/kg (IQR 8 to 18) and 9.2 (5.7 to 15.7), respectively. None of the characteristics differed significantly between survivors and nonsurvivors. The number of B-lines correlated to EVLWI (ρ = 0.45, P = 0.04; r2 = 0.20, P = 0.04), but not to NT-proBNP (ρ = -0.42, P = 0.06), OI (ρ = 0.25, P = 0.31) or ICU length of stay (ρ = 0.14, P = 0.57). On Bland-Altman analysis, mean differences and 95% limits of agreements between B-lines and EVLWI was 4.9 (-14.5 to 24.5), and 5.9 (-3.5 to 15.3) when assessing observer agreement. The ICC between methods was 0.52 (95% CI = -0.17 to 0.81) and 0.90 (95% CI = 0.73 to 0.92) between observers.


LUS non-invasively and user-independently quantifies lung water in concordance with, but does not replace, invasive measurements. Further studies are needed establish the role of LUS as a monitoring and diagnostic tool in septic shock patients.


  1. Frassi F, et al: J Card Fail. 2007, 13: 830-5. 10.1016/j.cardfail.2007.07.003.

    Article  PubMed  Google Scholar 

  2. Prosen G, et al: Crit Care. 2011, 15: R114-10.1186/cc10140.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Dellinger RP, et al: Intensive Care Med. 2013, 39: 165-228. 10.1007/s00134-012-2769-8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Geer, L.D., Oscarsson, A. & Gustafsson, M. Lung ultrasound in quantifying lung water in septic shock patients. Crit Care 19 (Suppl 1), P140 (2015).

Download citation

  • Published:

  • DOI: