Background: Patients receiving home care present clinically diverse forms of chronic respiratory failure, for which it is difficult to establish a definite diagnosis. CT diagnosis requires the patient to be transported, and obtaining the blood test results for the serum maker KL-6 requires a few days. Nevertheless, with the widespread use of portable ultrasound devices, we can now make an immediate ultrasound diagnosis of the lung in the home care setting. In our experience, most patients with deteriorated interstitialpneumonia show characteristic large disseminated B-lines or pleural effusion. This makes it possible to differentiate it from pneumonia, pulmonary emphysema, or cardiac insufficiency, which have similar clinical findings.
Purpose: To consider the possibility of using ultrasonography for the differential diagnosis of interstitial pneumonia.
Subjects: Eighteen patients with chronic respiratory failure receiving home care underwent ultrasonography and blood test(serum KL-6).
Methods: We examined the presence or absence of pleural effusion and B-line in patients who underwent lung echocardiogram examination and had a serum KL-6 level greater or less than 500 U/mL.
Results: All 8 patients with KL-6 levels greater than 500 U/mL showed B-lines or pleural effusion. However, only 2 of the 10 patients with KL-6 levels less than 500 U/mL showed B-lines.
Conclusion: Ultrasonography of patients with interstitial pneumonia, which is a cause of chronic respiratory failure, revealed a characteristic large and disseminated hyperechoic area. Although the number of patients was limited, we may consider ultrasonography effective for the diagnosis of interstitial pneumonia in the home care setting.