Fig. 1

Phased array transducer scanning in the transverse plane above the right lung base in the posterior axillary line. It is positioned at the expected chest drainage spot allowing measurements of the depth of pleural layers in the intercostal space which contributes to the safety of the procedure (upper). Consolidated right lower lobe in a patient on ECMO with circumferential effusion that separates the pleural layers paravertebrally (3 = Psep) 10 mm, dorsally (2 = Dsep) 21 mm and laterally (1 = Lsep) 20 mm (a pleural fluid, b consolidated lung parenchyma, c bronchogram, d rib). The drained volume of pleural fluid was 980 ml (middle). For comparison the original method of pleural fluid estimation [1] in another non-ECMO cardiac patient (bottom). The maximum separation of 32 mm at the lung base is multiplied by 20 giving a pleural volume estimate of 640 ml. Note no pleural separation and aerated lung under the posterolateral chest wall (a pleural fluid, b compressed lung parenchyma, c aerated lung, d rib)