(1)
Hôpital Ambroise Paré Service de Réanimation Médicale, Boulogne (Paris-West University), France
The pathophysiological basis of the BLUE-protocol shows that each acute condition able to generate a pleural effusion is also able to generate a lung consolidation (and vice versa, more logically). In acute pulmonary edema (hemodynamic and permeability induced), in pneumonia, and in pulmonary embolism, e.g., both disorders can exist together. In the aim of giving the most simple tool, we considered together effusion and consolidation. This simplification did not decrease the accuracy of the BLUE-protocol. Therefore, we present a new syndrome considering both disorders. The main outcome will be a faster training of the medical teams.
PLAPS (posterolateral alveolar and/or pleural syndrome) is a practical onomatopoeia (it can look like a splash), which figures out the image seen usually (Fig. 15.1). Let us analyze this term step by step.
Fig. 15.1
Typical PLAPS. Both disorders are seen together. A pleural effusion, identified between the pleural line (upper horizontal arrows) and the regular lung line (lower horizontal arrows). A lung consolidation, identified between the lung line and the fractal line (vertical arrows)
Posterolateral
Anterior pleural effusion is uncommon (this would usually suggest a huge effusion). Anterior consolidations are, we will see, highly suggestive of pneumonia. The PLAPS is, by definition, lateral or posterior. The traditional site for searching a PLAPS is the PLAPS-point.
Alveolar
This disorder will be described in Chap. 17.Related posts:
The Excluded Patients of the BLUE-Protocol: Who Are They? Did Their Exclusion Limit Its Value?
The BLUE-Protocol and the Diagnosis of Pneumonia
BLUE-Protocol and Acute Hemodynamic Pulmonary Edema
Lung Ultrasound Outside the Intensive Care Unit
Suggestion for Classifying Air Artifacts
Which Equipment for the BLUE-Protocol 2. The Probe
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