Usability of large animal models for lung ultrasound training and research

Abstract

Lung ultrasound (LUS), particular under aspects of pneumonia and cardiopulmonary insufficiency, requires specialised sonographic expertise as well as knowledge of its specific features. Due to restricted access to clinical cases such as with viral pneumonia, alternatively large animal models can be used for education and research. Therefore this work summarizes approaches for inducing pathologic LUS features on large animals. These will be classified regarding presentation of A/B-Lines, White Lung (WLS), pleural irregularities, consolidations and are further discussed regrading their cardio-pulmonary stability. Most commonly ARDS inducing lung lavage, oleic acid injection and endobronchial saline administration were published. Dominantly B-lines, WLS were found in all such models. Albeit a specialized technique using endobronchial saline instillation (OLF) visualised all LUS features as typical present during viral pneumonia, such as consolidations with air/fluid bronchogram, pleural irregularities and their patchy distribution with areas of aerated lung. With regard to haemodynamic and oxygenation stability, OLF provides best haemodynamic stability and enables reusable usability of animals. Non-infective large animal models can be used for safe, reliable education of clinicians for teaching practical handling of lung ultrasound and could serve for research aspects regarding ultrasound imaging or safety.