Indian Journal of Public Health Research & Development

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Prediction of Postoperative Pulmonary Complications by Ultrasonic Assessment of Extravascular Lung Water in Pediatric Patients with Left to Right Shunt Lesions


Affiliations
1 Department of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
2 Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
     

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Background: Postoperative pulmonary complications (PPC) can be associated with increased extra vascular lung water (EVLW) in patients with a cyanotic congenital heart disease (CHD). Lung ultrasonography (LUS) is a noninvasive, easily performed, bedside technique that allows assessment of EVLW.

Method: It is a prospective observational study of 80 pediatric patients with CHD with left to right shunt, scheduled for elective cardiac surgery. LUS were done preoperative, at end of surgery, then every 12 hours for 48 hours. Patients are given LUS score 0-36. LUS results were compared to incidence of PPC.

Results: LUS score showed rise from 1.4 ± 2.02 at LUS 0, to 5.6 ± 6.89 at LUS 1, followed by slow decrease over time: 4.35 ± 7.09, 3.15 ± 7.06, 2.68 ± 6.79, 2.32 ± 6.67. LUS score in patients complicated by PPC showed a significant difference from non-complicated patients; in all LUS scans.

Conclusion: LUS is a safe noninvasive technique that can help predict PPC, in pediatric cardiac patients presented for correction of left-to-right shunt lesions.


Keywords

Pediatric-Congenital Heart-Postoperative Pulmonary Complications - Lung Ultrasonography.
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  • Prediction of Postoperative Pulmonary Complications by Ultrasonic Assessment of Extravascular Lung Water in Pediatric Patients with Left to Right Shunt Lesions

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Authors

Mahmoud M. Elwakeel
Department of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Salwa M. Hefnawy
Department of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Mohamed Farouk Youssef
Department of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed Kareem M. Abdel Hady
Department of Anesthesia, Surgical ICU and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed M. Elwakeel
Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt

Abstract


Background: Postoperative pulmonary complications (PPC) can be associated with increased extra vascular lung water (EVLW) in patients with a cyanotic congenital heart disease (CHD). Lung ultrasonography (LUS) is a noninvasive, easily performed, bedside technique that allows assessment of EVLW.

Method: It is a prospective observational study of 80 pediatric patients with CHD with left to right shunt, scheduled for elective cardiac surgery. LUS were done preoperative, at end of surgery, then every 12 hours for 48 hours. Patients are given LUS score 0-36. LUS results were compared to incidence of PPC.

Results: LUS score showed rise from 1.4 ± 2.02 at LUS 0, to 5.6 ± 6.89 at LUS 1, followed by slow decrease over time: 4.35 ± 7.09, 3.15 ± 7.06, 2.68 ± 6.79, 2.32 ± 6.67. LUS score in patients complicated by PPC showed a significant difference from non-complicated patients; in all LUS scans.

Conclusion: LUS is a safe noninvasive technique that can help predict PPC, in pediatric cardiac patients presented for correction of left-to-right shunt lesions.


Keywords


Pediatric-Congenital Heart-Postoperative Pulmonary Complications - Lung Ultrasonography.