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Lung ultrasound reclassification of chest X‐ray data after pediatric cardiac surgery
Author(s) -
Cantinotti Massimiliano,
Ait Ali Lamia,
Scalese Marco,
Giordano Raffaele,
Melo Manuel,
Remoli Ettore,
Franchi Eliana,
Clemente Alberto,
Moschetti Riccardo,
Festa Pierluigi,
Haxiademi Dorela,
Gargani Luna
Publication year - 2018
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.13360
Subject(s) - medicine , atelectasis , pleural effusion , ultrasound , radiology , lung , lung ultrasound , cardiac surgery , effusion , surgery
Summary Introduction Lung ultrasound is gaining consensus for the diagnosis of some pulmonary conditions. Pulmonary complications are common in pediatric cardiac surgery. However, its use remains limited in this setting. Our aim was to test the feasibility of lung ultrasound following pediatric cardiac surgery and to compare lung ultrasound and chest X‐ray findings, assessing whether lung ultrasound may provide additional information. Methods One hundred and thirty‐eight lung ultrasound examinations were performed in 79 children (median age 9.3 months) at different time points after surgery. For each hemithorax, 3 areas (anterior/lateral/posterior) have been evaluated in the upper and lower halves of the chest (for a total of 6 scanning sites per side). Pleural effusion, atelectasis, and the number of B‐lines were investigated. Results Lung ultrasound was feasible in all cases in at least 1 of the 3 areas. Feasibility was different for the lateral, posterior, and anterior areas (100%, 90%, and 78%, respectively). The posterior areas were more sensitive than anterior and lateral ones in the diagnosis of effusion/atelectasis. In 81 cases, lung ultrasound allowed reclassification of chest X‐ray findings, including 40 new diagnoses (diagnosis of effusion/atelectasis with negative chest X‐ray reports) and 41 changes in diagnosis (effusions reclassified as atelectasis/severe congestion or vice versa). Although new diagnosis of small‐to‐moderate effusion/atelectasis was of limited clinical value, in 29 cases the new diagnosis changed the therapeutic approach. Conclusion 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.