The use of lung ultrasound to assess the prevalence of lung interstitial syndrome in paediatric cardiac surgery patients and the measurement of postoperative length of hospital stay

Abstract

Background: In recent years, ultrasound has gained popularity in the assessment of pulmonary pathology, especially in the critical care setting. However, limited data are available for the use of lung ultrasound (LUS) for the diagnosis of lung interstitial syndrome (LIS) in the paediatric cardiac surgery population. Methods: The aim of this observational cross-sectional study primarily was to assess the prevalence of LIS due to extravascular lung water (EVLW) in paediatric patients with high pulmonary-flow congenital cardiac lesions. Patients who underwent corrective open heart surgery were scanned immediately post-operatively and B-lines in each of eight thoracic areas were counted. LIS was diagnosed or ruled out based on this result. Secondary outcomes were postoperative length of stay (LOS) in Cardiothoracic Unit (CTU) and in hospital and whether LIS is associated with prolonged LOS. Results: Twenty children aged between 6 months and 9 years were included in this study. The prevalence of LIS was found to be 25%. The median LOS in the CTU for children diagnosed with LIS was 4.0 days (range 3.0 to 6.0) and median length of hospital stay was 7.5 days (range 6.0 to 20.0). There was no statistical difference in CTU LOS (p = 0.601) or hospital LOS (p = 0.544) between the groups with or without LIS. Conclusion: Pulmonary complications are common after surgery for congenital heart disease. This study showed a prevalence of LIS of 25%. This can potentially result in increased morbidity and mortality, but the study sample was too small to prove this. LUS can be used for early identification and management of complications.