An old patient with a history of COPD was admitted to the ICU for hypercapnic respiratory failure (pCO2 92 mmHg, pO2 70 mmHg, pH 7.3, BE +18 mmol/l). Level of consciousness improved after non-invasive ventilation was started. Auscultation revealed diffuse rhonchi. No expectoration was present. Chest X-ray performed during admission revealed neither infiltration nor effusion. Lab tests showed elevated levels of inflammatory markers (20 000 leucocytes with 78% of neutrophils, CRP 53 mg/l).
Lung ultrasonography was performed: