Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Original Investigation

Assessment of lung ultrasound for early detection of respiratory complications in thoracic surgery

Avaliação da ultrassonografia pulmonar para detecção precoce de complicações respiratórias em cirurgia torácica

Laetitia Bosch; Olivier Mathe; Jean-Jacques Robin; Isabelle Serres; François Labaste; Pierre Masquère; Maxime Grigoli; Laurent Brouchet; Jean-Marie Conil; Vincent Minville

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Background and objectives: To assess lung ultrasound for the diagnosis and monitoring of respiratory complications in thoracic surgery.

Methods: 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.

Results: 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.

Conclusion: Lung ultrasound can help in the diagnosis of respiratory complications following pulmonary resection surgery.


Ultrasound, Thoracic surgery, Complications, Bedside


Justificativa e objetivos: Avaliar a ultrassonografia pulmonar para o diagnóstico e acompanhamento das complicações respiratórias em cirurgia torácica. 

Métodos: Estudo prospectivo observacional em hospital universitário, única instituição. Pacientes adultos programados para cirurgia de ressecção pulmonar, excluindo pneumectomia. O acompanhamento ultrassonográfico foi realizado do dia anterior à cirurgia até o terceiro dia após a cirurgia com cálculo da linha B e escore pulmonar (escores de reaeração e perda de aeração). As complicações respiratórias foram coletadas durante todo o período de internação.

Resultados: Cinquenta e seis pacientes foram incluídos. Dezoito pacientes apresentaram complicação respiratória (32%) e apresentaram IMC e pontuação ASA significativamente maiores. Os pacientes operados por videotoracoscopia apresentaram menor risco de complicações. No dia 3, um escore de reaeração ≤ 2 no lado ventilado ou ≤ -2 no lado operado e um escore de linha B> 6 no lado operado foram a favor de uma complicação.

Conclusão: A ultrassonografia pulmonar pode auxiliar no diagnóstico de complicações respiratórias após cirurgia de ressecção pulmonar.


Ultrassom, Cirurgia toráxica, Complicações, Leito


1 Fernandes EO, Teixeira C, Silva LCCD. Thoracic surgery: risk factors for postoperative complications of lung resection. Rev Assoc Med Bras. 2011;57:292-8.

2 Yao H-Y, Liu T-J, Lai H-C. Risk factors for intraoperative hypoxemia during monopulmonary ventilation: an observational study. Rev Bras Anestesiol. 2019;69:390-5.

3 Lohser J. Evidence-based management of one-lung ventilation. Anesthesiol Clin. 2008;26:241-72.

4 Levitov A, Frankel HL, Blaivas M, 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. 2016;44:1206-27.

5 Lichtenstein D, Goldstein I, Mourgeon E, et al. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome. Anesthesiology. 2004;100:9-15.

6 Brooke M, Walton J, Scutt D, et al. Acquisition and interpretation of focused diagnostic ultrasound images by ultrasound-naive advanced paramedics: trialling a PHUS education programme. Emerg Med J. 2012;29:322-6.

7 See KC, Ong V, Wong SH, et al. Lung ultrasound training: curriculum implementation and learning trajectory among respiratory therapists. Intensive Care Med. 2016;42:63-71.

8 Goudie E, Bah I, Khereba M, et al. Prospective trial evaluating sonography after thoracic surgery in postoperative care and decision making. Eur J Cardiothorac Surg. 2012;41:1025-30.

9 Soldati G, Sher S. Bedside lung ultrasound in critical care practice. Minerva Anestesiol. 2009;75:509-17.

10 Soldati G, Copetti R, Sher S. Sonographic interstitial syndrome: the sound of lung water. J Ultrasound Med. 2009;28:163-74.

11 García-de-la-Asunción J, García-del-Olmo E, Perez-Griera J, 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. 2015;48:e37-44.

12 Vidal Melo MF, Musch G, Kaczka DW. Pulmonary pathophysiology and lung mechanics in anesthesiology: a case-based overview. Anesthesiol Clin. 2012;30:759-84.

13 Olivant Fisher A, Husain K, Wolfson MR, et al. Hyperoxia during one lung ventilation: inflammatory and oxidative responses. Pediatr Pulmonol. 2012;47:979-86.

14 Bouhemad B, Mongodi S, Via G, et al. Ultrasound for ‘‘lung monitoring’’ of ventilated patients. Anesthesiology. 2015;122:437-47.

15 Bouhemad B, Brisson H, Le-Guen M, et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment. Am J Respir Crit Care Med. 2011;183:341-7.

16 Rocca Della G, Coccia C. Acute lung injury in thoracic surgery. Current Opinion in Anaesthesiology. 2013;26:40-6.

17 Guay J, Ochroch EA. 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:CD011151.

18 Licker M, Diaper J, Villiger Y, et al. Impact of intraoperative lung-protective interventions in patients undergoing lung cancer surgery. Crit Care. 2009;13:R41.

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