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Lung ultrasound accuracy to predict ventilatory outcomes after paediatric cardiac surgery

Published online by Cambridge University Press:  19 May 2025

Raíssa Q. Rezende Open the ORCID record for Raíssa Q. Rezende [Opens in a new window] ,
Clarice L.S. Lopes ,
Claudia P. Ricachinevsky  and
Jefferson P. Piva
Raíssa Q. Rezende*
Affiliation:
Pediatric Intensive Care Unit, Hospital da Criança Santo Antônio, Porto Alegre, Brazil Department of Pediatric, Federal University of Health Science of Porto Alegre, Porto Alegre, Brazil
Clarice L.S. Lopes
Affiliation:
Pediatric Intensive Care Unit, Hospital da Criança Santo Antônio, Porto Alegre, Brazil
Claudia P. Ricachinevsky
Affiliation:
Pediatric Intensive Care Unit, Hospital da Criança Santo Antônio, Porto Alegre, Brazil
Jefferson P. Piva
Affiliation:
Pediatric Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Pediatric, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
*
Corresponding author: Raíssa Queiroz Rezende; Email: raissaq@gmail.com
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Abstract

Background:

Pulmonary oedema is a common complication after paediatric cardiac surgery, and it is linked to increased morbidity. Lung ultrasound has been recognised as an alternative to chest radiography, offering rapid and accurate diagnosis without exposure to ionising radiation.

Methods:

The study aimed to investigate the association between the severity of pulmonary oedema identified through a B-lines score—a lung ultrasound score used to assess the severity of pulmonary oedema—and ventilatory outcomes in the postoperative period of cardiac surgery. It was a prospective single-centre cohort study conducted at a quaternary paediatric hospital. Patients up to 18 years old who underwent cardiac surgery for CHD were included. The primary outcome was extubation failure within 48 hours after surgery, and the secondary outcome was mechanical ventilation time.

Results:

Among the 131 included patients, 116 were extubated with an extubation failure rate of 18.3%. Patients with extubation failure were younger and had a longer duration of mechanical ventilation. A robust association between higher B-lines score on lung ultrasound within the first 24 hours after surgery and extubation failure was observed (p < 0.001). The correlation between B-lines score and mechanical ventilation time was positive, with stronger correlation preoperatively.

Conclusions:

Severe pulmonary oedema detected through lung ultrasound in the first postoperative day of paediatric cardiac surgery show better accuracy to predict patients at greater risk of extubation failure and prolonged mechanical ventilation.

Keywords

Lung ultrasoundCHDpaediatric cardiac surgeryextubation failure

Information

Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 5 , May 2025 , pp. 1011 - 1015
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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