Background Postoperative hypoxemia is associated with morbidity and mortality. We aim to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose pulmonary complications in patients suffering from hypoxemia after general anesthesia, and compare to thoracic computed tomography (CT).Methods Adult patients received general anesthesia and suffered from hypoxemia in the PACU, were analyzed. Hypoxemia was defined as a SPO2 less than 92% for greater than 30 seconds on room air. LUS was performed by a trained anesthesiologist once hypoxemia occurred. After LUS examination, each patient was transported to radiology department for thoracic CT scan within 1 hour before returning to the ward.Results From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopedics surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) and other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%).Conclusions Lung ultrasound is feasible, efficient and accurate in diagnosing different etiologies of postoperative hypoxia in the PACU.
Background: Postoperative pulmonary complications (PPCs) and hypoxaemia is associated with morbidity and mortality. We aim to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose PPCs in patients suffering from hypoxemia after general anesthesia and compare the results to those of thoracic computed tomography (CT). Methods: Adult patients who received general anesthesia and suffered from hypoxaemia in the postanaesthesia care unit (PACU) were analyzed. Hypoxaemia was defined as an oxygen saturation measured by pulse oximetry (SPO 2 ) less than 92% for more than 30 seconds under ambient air conditions. LUS was performed by two trained anaesthesiologists once hypoxaemia occurred. After LUS examination, each patient was transported to the radiology department for thoracic CT scan within 1 hour before returning to the ward. Results: From January 2019 to May 2019, 113 patients (61 men) undergoing abdominal surgery (45 patients, 39.8%), video-assisted thoracic surgery (31 patients, 27.4%), major orthopaedic surgery (17 patients, 15.0%), neurosurgery (10 patients, 8.8%) or other surgery (10 patients, 8.8%) were included. CT diagnosed 327 of 1356 lung zones as atelectasis, while LUS revealed atelectasis in 311 of the CT-confirmed zones. Pneumothorax was detected by CT scan in 75 quadrants, 72 of which were detected by LUS. Pleural effusion was diagnosed in 144 zones on CT scan, and LUS detected 131 of these zones. LUS was reliable in diagnosing atelectasis (sensitivity 98.0%, specificity 96.7% and diagnostic accuracy 97.2%), pneumothorax (sensitivity 90.0%, specificity 98.9% and diagnostic accuracy 96.7%) and pleural effusion (sensitivity 92.9%, specificity 96.0% and diagnostic accuracy 95.1%). Conclusions: Lung ultrasound is feasible, efficient and accurate in diagnosing different aetiologies of postoperative hypoxia in healthy-weight patients in the PACU.
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