Current use and practices of lung ultrasound in geriatric care: insights from a national survey

Background: Lung ultrasound (LUS) has gained increasing relevance in the evaluation of respiratory symptoms due to its bedside applicability, diagnostic accuracy, and safety. However, its adoption in geriatric care remains limited. Aims: This study aimed to assess current LUS availability, use, and technical practices among Italian geriatricians. Methods: A nationwide, cross-sectional survey was conducted among members of the Italian Society of Gerontology and Geriatrics. The 44-item questionnaire explored LUS availability, use, indications, and technical practices in acute care. LUS proficiency was operationally defined as the ability to perform the scan, interpret findings and integrate them with clinical data independently or under supervision. Results: Responders (n = 154), representing 57 hospitals in 17 Italian regions, reported wide interest in LUS and recognized its utility for improving the care of older patients with acute respiratory failure. The main indications, which LUS was used for in their clinical experience, were assessment of volume status, pleural effusions and heart failure. Although availability of LUS equipment in the clinical units of responders was generally high (94%), 27.3% of them were non-proficient in LUS and more than 85% reported that a trained operator was not available 24/7. Heterogeneity also emerged in examination techniques and reporting among LUS-proficient responders, with only 6% adopting validated scanning protocols and 13% using standardized reporting formats. Conclusion: This survey reveals limited integration of LUS in geriatric care with heterogeneous practices. Structured training pathways and geriatric-specific standardized LUS protocols are urgently needed to enable broader, safer, and more consistent implementation in acute geriatric care.