Ecografía pulmonar en final de vida en domicilio: una nueva aproximación diagnóstica para un conocimiento de la fisiopatología del morir. Serie de casos.

Abstract

Introduction: Pulmonary ultrasound has not yet been used to determine the state of the lung and its evolution in the course of a terminal illness. The objective of this work is to know how the lung behaves in people at the end of life using "point of care ultrasound" at home and to detect the benefits that this procedure will have for the patient, the family and the future of palliative medicine. The ultrasound machine used is digital and it is the probe itself, weighing 313░g and 185░×░56░×░35░mm dimensions, attached to a device with a variable-size screen, easy to carry. A systematic examination, in 2-dimensional mode, of four points was made in each hemitorax and three cardiac views. Patients and methods: Observational study sample of seven patients referred, between May and July 2020, to our home palliative care team and who died within 72░hours after performing lung ultrasound: 2 with cancer, another with Parkinson's disease and 4 without a clear cause of death. Results: The pleural line was altered in all cancer patients which also presented a pleural effusion and another one a pericardial effusion with a variable edema of the lung parenchyma; 3 of them had reduced ventricular function. The Parkinson's patient had a normal aerated lung but significant respiratory dysfunction. Discussion: Lung ultrasound offers relevant information for professionals by improving the diagnostic capacity at the end of life and those causes of death, identify pleural and pericardial effusions, will make it possible to optimize therapeutic decisions.