Thoracic ultrasound in guiding management of respiratory disease.

Theuse of ultrasound in respiratory disease has evolved substantially over thepast two decades. From a test done to confirm the safe site of pleural fluiddrainage, thoracic ultrasound has become a point-of-care test that guides themanagement of patients on respiratory wards, in clinics and endoscopy. This review overviews of process ofultrasound examination in the chest. It then delves into specific disease areas(pleural disease, lung disease, diaphragm disease, and invasive procedures) tohighlight how thoracic ultrasound is being used to refine management. Thereview concludes with discussion on the training curricula and assessment toolsfor competency in thoracic ultrasound. Being a scoping review, literaturesearches were conducted on PubMed using relevant search terms. Inaddition to its current uses, there are many avenues where thoracic ultrasound willsoon be beneficial. Recent studies show promising roles in areas such aspatient-tailored guidance of pleurodesis and non-invasively predicting lungre-expansion after pleural fluid drainage. In addition, auxiliary tools such ascontrast-enhanced ultrasound and elastography are proving useful in identifyingthe etiology and directing the successful sample of pleural and lung lesions. Studiesare also exploring the utility of sonographic biomarkers such as echogenicity andseptations to predict outcomes in pleural disease.