Ультразвуковое Исследование Легких В Отделении Анестезиологии-Реанимации Детского Кардиохирургического Профиля: Обзор Литературы

Abstract

INTRODUCTION: Pediatric cardiac surgery is associated with a high risk of developing acute respiratory failure in the early postoperative period. An anesthesia and intensive care specialist has to make effective and quick decisions of the intensive care tactics considering the severity of the children’s condition, limited capacity of transporting and radiation exposure. As a result, there is the demand for a simple, quick, safe and highly sensitive method available to the anesthesia and intensive care specialist at the bedside, which may be met through implementation of routine lung ultrasound. OBJECTIVE: To combine, organize and analyze the data on application of lung ultrasound as a bedside diagnostic method in pediatric cardiac surgery. MATERIALS AND METHODS: Two independent researchers conducted a systematic review of articles published within the period from 2013 to 2023 in English (PubMed, Google Scholar) and Russian (eLibrary, Google Scholar) databases according to the PRISMA protocols. The search was based on the queries: “lung ultrasound”, “children”, “cardiac surgery”, “respiratory failure” in both English and Russian. The overall search result was 528 articles in English with 494 excluded from search after title and abstract reading. A total of 34 articles were considered for inclusion with 20 falling under at least one exclusion criterion. The final selection for detailed analysis was 14 articles. In Russian, a total of 897 articles were found, all of which were considered inappropriate for a systematic review. RESULTS: A total of 14 articles were studied to reveal information on the role of lung ultrasound in pediatric cardiac surgery as a method for diagnosis and assessment of interstitial syndrome, atelectasis, pneumothorax, diaphragmatic function and complex combined lung diseases. The utility of perioperative lung ultrasound and the effect of recruitment maneuver under ultrasound guidance as well as ultrasound predictors of successful tracheal extubation were assessed in children after cardiac surgery. CONCLUSIONS: The literature analysis has revealed that this bedside diagnostic method makes it possible to diagnose pulmonary edema, atelectasis, pneumothorax, to assess the diaphragmatic function, to perform visually guided recruitment maneuver as well as to predict successful tracheal extubation in pediatric cardiac surgery.