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Acute respiratory failure is one of the most challenging critical conditions due to a wide variety of di!erential diagnosis. Bedside lung ultrasound in emergency (BLUE) protocol allows accurate di!erentiation between the most common underlying causes of acute respiratory failure in up to 90% of the cases. "e assessment of le# atrial pressure a!ecting le# ventricular $lling is essential in critically ill patients guiding volume substitution, optimization of le# ventricular function and prevention of pulmonary congestion, thus ensuing haemodynamic stability. A simple, non-invasive method of le# atrial pressure evaluation is the echocardiographic assessment of interatrial septum shape and motion, which is a!ected by interatrial pressure gradient. Aiming to improve the accuracy of the BLUE protocol, we propose the simple, non-invasive echocardiographic assessment of interatrial septum shape and motion as an upgrade, providing additional information of the loading of le# and right atrium thus distinguishing the most common causes of acute respiratory failure.

Can echocardiographic assessment of interatrial septum shape and motion improve the accuracy of the BLUE protocol?