Supplementary Material for: Clinical Use and Barriers of Thoracic Ultrasound: A Survey of Italian Pulmonologists

<b><i>Introduction:</i></b> Thoracic ultrasound is accurate in the diagnosis of a wide range of respiratory diseases. Yet the extent of its use is unknown. Through a national survey, we aimed to explore the clinical use of thoracic ultrasound and the barriers to the diffusion of the technique in Italy. <b><i>Methods:</i></b> Accademia di Ecografia Toracica (AdET) developed a self-administered survey which was sent by email to Italian pulmonologists via national scientific societies and networks. <b><i>Results:</i></b> Of the 2010 physicians invited, 514 completed the survey (26% response rate). According to 99% of responders, thoracic ultrasound had a relevant clinical role. Seventy-nine percent of the responders used thoracic ultrasound at least once a month. The main settings were: 53% pulmonology ward, 15% outpatient clinic, 15% interventional pulmonology room, 10% internal medicine ward, 4% respiratory intensive care units, and 9% other. Thoracic ultrasound was primarily used: (1) with both diagnostic and interventional aims (72%), (2) as diagnostic imaging (17%), and (3) as guidance for interventional procedures (11%). The main clinical applications were: (1) diagnosis and management of pleural effusion, (2) pneumothorax, (3) pneumonia, (4) cardiac failure, and (5) acute dyspnea. Twenty-one percent of the responders do not use thoracic ultrasound. The main reported bar­riers were: (1) availability of an ultrasound system (52%), (2) lack of protected time and training (22%), and (3) use of the technique by other specialists (15%). <b><i>Conclusion:</i></b> Thoracic ultrasound is widely used by Italian pulmonologists and considered a clinically relevant tool. The availability of dedicated ultrasound systems seems to be a major limit of the use of the technique.

**<i>引言：</i>**
胸部超声（Thoracic ultrasound）对多种呼吸系统疾病的诊断具有较高准确性，但其临床应用普及程度尚未明确。本研究通过开展全国性调查，旨在探讨胸部超声在意大利的临床应用现状及该技术推广面临的障碍。
**<i>研究方法：</i>**
意大利胸超声学会（Accademia di Ecografia Toracica, AdET）开发了一份自填式调查问卷，通过全国性学术学会及协作网络以电子邮件形式发送给意大利肺科医师。
**<i>研究结果：</i>**
本次共邀请2010名医师参与调查，最终514人完成有效问卷，有效回收率为26%。99%的受访者认为胸部超声具备重要临床价值。79%的受访者每月至少使用一次胸部超声。其主要应用场景为：53%位于肺科病房，15%位于门诊诊所，15%位于介入肺科诊室，10%位于内科病房，4%位于呼吸重症监护病房，另有9%分布于其他场景。胸部超声的主要应用目的包括：（1）兼具诊断与介入操作指导双重用途（72%），（2）仅用于诊断成像（17%），（3）仅用于介入操作引导（11%）。其核心临床应用方向依次为：（1）胸腔积液的诊断与管理，（2）气胸，（3）肺炎，（4）心力衰竭，（5）急性呼吸困难。另有21%的受访者从未使用过胸部超声。受访者提及的主要推广障碍包括：（1）超声设备供应不足（52%），（2）缺乏充足的专属时间与培训资源（22%），（3）其他专科医师已开展该技术的临床应用（15%）。
**<i>结论：</i>**
胸部超声已在意大利肺科医师中得到广泛应用，并被视为具有重要临床价值的工具。专用超声设备的匮乏似乎是制约该技术推广的主要瓶颈。