Lung ultrasound reclassification of chest X‐ray data after pediatric cardiac surgery

Cantinotti, Massimiliano; Ait-Alì, Lamia; Scalese, Marco; Giordano, Raffaele; Melo, M; Remoli, Ettore; Franchi, Eliana; Clemente, Alberto; Moschetti, Riccardo; Festa, Pierluigi; Haxiademi, Dorela; Gargani, Luna

doi:10.1111/pan.13360

Cited by 35 publications

(40 citation statements)

References 25 publications

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“…(Ann Thorac Surg 2020;109:178-84) Ó 2020 by The Society of Thoracic Surgeons L ung ultrasound (LUS) is a noninvasive, easy, and fast technique for the evaluation of pulmonary disease in children, especially in the acute setting. [1][2][3][4][5][6][7][8] Pulmonary complications are common with pediatric cardiac surgery and have been evaluated primarily with chest roentgenograms. [4][5][6][7] Recent studies have evaluated the utility of LUS in children undergoing congenital heart surgery.…”

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confidence: 99%

“…[1][2][3][4][5][6][7][8] Pulmonary complications are common with pediatric cardiac surgery and have been evaluated primarily with chest roentgenograms. [4][5][6][7] Recent studies have evaluated the utility of LUS in children undergoing congenital heart surgery. [4][5][6][7] These studies have shown diagnostic accuracy of LUS for pulmonary complications after surgery including pleural effusion, atelectasis, pneumothorax, and pneumonia.…”

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confidence: 99%

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Prognostic Value of a New Lung Ultrasound Score to Predict Intensive Care Unit Stay in Pediatric Cardiac Surgery

Cantinotti

Giordano

Scalese

et al. 2020

The Annals of Thoracic Surgery

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confidence: 99%

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confidence: 99%

Prognostic Value of a New Lung Ultrasound Score to Predict Intensive Care Unit Stay in Pediatric Cardiac Surgery

Cantinotti

Giordano

Scalese

et al. 2020

The Annals of Thoracic Surgery

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“…LUS has been used to diagnose a variety of lung diseases such as pneumonia, pleural effusion, and consolidation, with high accuracy. 17,18,23 Our study showed the sensitivity and accuracy of LUS However, LUS has the advantage of being more sensitive than CXR in pleural effusion, pneumothorax, and consolidation in previous study. 17 Furthermore, one study showed that CHD newborns with suspected PO had a significant increase of B lines in LUS, before PO was detected by CXR, by echocardiography or by clinical examination.…”

Section: Discussionmentioning

confidence: 52%

“…LUS has been used to diagnose a variety of lung diseases such as pneumonia, pleural effusion, and consolidation, with high accuracy . Our study showed the sensitivity and accuracy of LUS were 94% and 95%, respectively, while CXR had only 74% sensitivity and 63% accuracy, for the diagnosis of PO.…”

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confidence: 73%

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Feasibility of lung ultrasound to assess pulmonary overflow in congenital heart disease children

Hou

Lǚ

et al. 2018

Pediatric Pulmonology

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Background Pulmonary overflow (PO) is one of the most common complications in congenital heart disease (CHD) children with an incidence of 48‐60% approximately. This study explored the feasibility of using lung ultrasound (LUS) to assess pulmonary overcirculation in CHD children and compare the diagnostic performance of LUS and chest radiography (CXR) for the detection of pulmonary overcirculation. Method The upper anterior area, lower anterior area, upper lateral area, and lower posterior area, in each hemithorax were scanned in 59 children in the supine position. A‐lines, B‐lines in each scanned region were recorded, and the worst LUS abnormality in the video clip was considered to characterize the examined region. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of LUS and CXR were compared using computed tomography (CT) as a standard criterion. Results PO was diagnosed in 53% (31/59), 63% (37/59), and 51% (30/59) children with CT, CXR, and LUS, respectively. The sensitivity, specificity, and diagnostic accuracy of PO were 96%, 94%, and 95% for LUS and 74%, 50%, and 63% for CXR. The percentage of mild, moderate, and severe PO diagnosed via LUS were 31% (18/59), 19% (11/59), and 2% (1/59), respectively. Furthermore, the PO incidence diagnosed by LUS in CHD children less than 1 year old were significantly higher than those beyond 1 year old. Conclusion LUS is a noninvasive and useful tool for the detection and assessment of PO in CHD children at the operating room, and is better than CXR in sensitivity and specificity, comparable to CT.

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Lung ultrasound evaluation of incremental PEEP recruitment maneuver in children undergoing cardiac surgery

Sun

Zhang

et al. 2020

Pediatric Pulmonology

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Aim To explore the effect of incremental positive end‐expiratory pressure recruitment maneuver (iPEEPRM) in children with congenital heart diseases (CHDs) using lung ultrasound. Methods Thirty‐six children aged 3 months to 5 years scheduled for cardiac surgery participated. iPEEPRM was performed with PEEP stepwise increase (0‐5‐10‐15 cmH2O) and decrease at the same rate before and after surgery. Atelectatic areas, ultrasound scores, arterial oxygen pressure (PaO2), and respiratory system dynamic compliance per kilogram body weight (CDyn/kg) were analyzed before and after iPEEPRM. The primary outcome is the incidence of atelectasis. Secondary outcomes are oxygenation, ventilation, CDyn/kg, and atelectasis area. Results iPEEPRM was successfully applied in 92% (33/36) children before surgery and 71% (24/34) children after surgery. The incidence of atelectasis was significantly reduced by iPEEPRM from 76% to 15% before surgery and from 92% to 38% after surgery, respectively (P < .001). Before surgery, iPEEPRM significantly reduced atelectatic areas and ultrasound scores: 32.5 (0‐128.1) mm2 vs 0 (0‐0) mm2 and 8 (3‐12) vs 2 (0‐4). PaO2 and CDyn/kg were significantly increased after iPEEPRM: 243 (129‐275) mm Hg vs 278 (207‐323) mm Hg and 0.6 (0.4‐0.7) mL/cmH2O/kg vs 0.8 (0.6‐1.0) mL/cmH2O/kg. After surgery, iPEEPRM significantly reduced atelectatic areas and ultrasound scores: 45.7 (13.1‐115.8) mm2 vs 0 (0‐34.7) mm2, and 9 (6‐12) vs 3 (0‐5). PaO2 and CDyn/kg were also significantly increased after iPEEPRM. Conclusions iPEEPRM effectively reduced atelectasis, improved lung aeration, oxygenation, and CDyn/kg in children undergoing cardiac surgery.

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Lung ultrasound reclassification of chest X‐ray data after pediatric cardiac surgery

Abstract: Lung ultrasound is feasible and accurate for the diagnosis of common pulmonary conditions after pediatric cardiac surgery, allowing reclassification of chest X-ray findings in a significant number of patients.

Cited by 35 publications

References 25 publications

Prognostic Value of a New Lung Ultrasound Score to Predict Intensive Care Unit Stay in Pediatric Cardiac Surgery

Prognostic Value of a New Lung Ultrasound Score to Predict Intensive Care Unit Stay in Pediatric Cardiac Surgery

Feasibility of lung ultrasound to assess pulmonary overflow in congenital heart disease children

Lung ultrasound evaluation of incremental PEEP recruitment maneuver in children undergoing cardiac surgery

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