Assessment of lung ultrasound for early detection of respiratory complications in thoracic surgery
Laetitia Bosch, Olivier Mathe, Jean-Jacques Robin, Isabelle Serres, Franc¸ois Labaste, Pierre Masqu`ere, Maxime Grigoli, Laurent Brouchet, Jean-Marie Conil, Vincent Minville
Background and objectives
To assess lung ultrasound for the diagnosis and monitoring of respiratory complications in thoracic surgery.
Prospective observational study in a University hospital, single institution. Adult patients scheduled for pulmonary resection surgery excluding pneumonectomy. An ultrasound follow-up was performed from the day before the surgery to the third day after surgery with calculation of B-line and lung score (reaeration and loss of aeration scores). Respiratory complications were collected throughout the hospitalization period.
Fifty-six patients were included. Eighteen patients presented a respiratory complication (32%), and they presented significantly higher BMI and ASA scores. Patients operated by videothoracoscopy were less at risk of complications. At day 3, a reaeration score ≤ 2 on the ventilated side or ≤ -2 on the operated side, and a B-line score > 6 on the operated side were in favor of a complication.
Lung ultrasound can help in the diagnosis of respiratory complications following pulmonary resection surgery.
1 E.O. Fernandes, C. Teixeira, L.C.C.D. Silva Thoracic surgery: risk factors for postoperative complications of lung resection Rev Assoc Med Bras., 57 (2011), pp. 292-298
2 H.-Y. Yao, T.-J. Liu, H.-C. Lai Risk factors for intraoperative hypoxemia during monopulmonary ventilation: an observational study Rev Bras Anestesiol., 69 (2019), pp. 390-395
3 J. Lohser Evidence-based management of one-lung ventilation Anesthesiol Clin., 26 (2008), pp. 241-272
4 A. Levitov, H.L. Frankel, M. Blaivas, et al. Guidelines for the Appropriate Use of Bedside General and Cardiac Ultrasonography in the Evaluation of Critically Ill Patients-Part II: Cardiac Ultrasonography Crit Care Med., 44 (2016), pp. 1206-1227
5 D. Lichtenstein, I. Goldstein, E. Mourgeon, et al. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome Anesthesiology., 100 (2004), pp. 9-15
6 M. Brooke, J. Walton, D. Scutt, et al. Acquisition and interpretation of focused diagnostic ultrasound images by ultrasound-naive advanced paramedics: trialling a PHUS education programme Emerg Med J., 29 (2012), pp. 322-326
7 K.C. See, V. Ong, S.H. Wong, et al. Lung ultrasound training: curriculum implementation and learning trajectory among respiratory therapists Intensive Care Med., 42 (2016), pp. 63-71
8 E. Goudie, I. Bah, M. Khereba, et al. Prospective trial evaluating sonography after thoracic surgery in postoperative care and decision making Eur J Cardiothorac Surg., 41 (2012), pp. 1025-1030
9 G. Soldati, S. Sher Bedside lung ultrasound in critical care practice Minerva Anestesiol., 75 (2009), pp. 509-517
10 G. Soldati, R. Copetti, S. Sher Sonographic interstitial syndrome: the sound of lung water J Ultrasound Med., 28 (2009), pp. 163-174
11 J. García-de-la-Asunción, E. García-del-Olmo, J. Perez-Griera, et al. Oxidative lung injury correlates with one-lung ventilation time during pulmonary lobectomy: a study of exhaled breath condensate and blood Eur J Cardiothorac Surg., 48 (2015), pp. e37-e44
12 M.F. Vidal Melo, G. Musch, D.W. Kaczka Pulmonary pathophysiology and lung mechanics in anesthesiology: a case-based overview Anesthesiol Clin., 30 (2012), pp. 759-784
13 A. Olivant Fisher, K. Husain, M.R. Wolfson, et al. Hyperoxia during one lung ventilation: inflammatory and oxidative responses Pediatr Pulmonol., 47 (2012), pp. 979-986
14 B. Bouhemad, S. Mongodi, G. Via, et al. Ultrasound for “lung monitoring” of ventilated patients Anesthesiology., 122 (2015), pp. 437-447
15 B. Bouhemad, H. Brisson, M. Le-Guen, et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment Am J Respir Crit Care Med., 183 (2011), pp. 341-347
16 G. Rocca Della, C. Coccia Acute lung injury in thoracic surgery Current Opinion in Anaesthesiology, 26 (2013), pp. 40-46
17 J. Guay, E.A. Ochroch Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in patients without acute lung injury Cochrane Database Syst Rev. (2015), p. CD011151
18 M. Licker, J. Diaper, Y. Villiger, et al. Impact of intraoperative lung-protective interventions in patients undergoing lung cancer surgery Crit Care., 13 (2009), p. R41