Feasibility and efficacy of lung ultrasound to investigate pulmonary complications in patients who developed postoperative Hypoxaemia-a prospective study

Abstract

Background: Postoperative pulmonary complications (PPCs) and hypoxaemia are associated with morbidity and mortality. We aimed to evaluate the feasibility and efficacy of lung ultrasound (LUS) to diagnose PPCs in patients suffering from hypoxaemia after general anaesthesia and compare the results to those of thoracic computed tomography (CT). Methods: Adult patients who received general anaesthesia and suffered from hypoxaemia in the postanaesthesia care unit (PACU) were analysed. Hypoxaemia was defined as an oxygen saturation measured by pulse oximetry (SPO 2) less than 92% for more than 30 s 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 h 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.

Artificial Bee Colony Algorithm-Based Ultrasound Image Features in the Analysis of the Influence of Different Anesthesia Methods on Lung Air Volume in Orthopedic Surgery Patients

“…e results showed that patients in the algorithm group were more likely to have decreased lung gas content after operation than those in the control group under the same anesthesia. is result was also consistent with other studies [20][21][22][23][24].…”

Comparing accuracy of bedside ultrasound examination with physical examination for detection of pleural effusion

“…Our supine US examination results (sensitivity of 98%, specificity 94.4%, a diagnostic accuracy of 97.1%) are consistent with existing literature. A pooled sensitivity of 93% and specificity of 96% were noted in a prior systematic review [ 16 ], while a diagnostic accuracy of 95.1% was previously reported [ 20 ]. In contrast, for dullness to percussion, our positive LR 1.13 is lower than the previously reported LR of 8.7, although a wide 95% CI (2.2–33.8) was noted [ 5 ].…”

Comparison of the effects of neostigmine and sugammadex on postoperative residual curarization and postoperative pulmonary complications by means of diaphragm and lung ultrasonography: a study protocol for prospective double-blind randomized controlled trial

“…Lung ultrasound will be facilitated to detect atelectasis, pneumonia, or pulmonary effusion, which are common pulmonary complications. Unfortunately, although some researches are indicating the high sensibility and specificity of LUS to diagnose atelectasis, pneumothorax, and pleural effusion [ 31 , 32 , 43 ], with a diagnostic accuracy of over 90% [ 43 ], there is no consensus on lung ultrasound to diagnose PPCs yet. We, therefore, aim to link the incidence of PPCs to lung ultrasound by analyzing the postoperative ultrasound imaging score and follow-up procedures straight into 30 days after their surgeries.…”