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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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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.
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