Lung ultrasound in the evaluation of pulmonary edema in newborns with critical congenital heart disease

IF 2.3 4区 医学 Q2 PEDIATRICS
Basak Kaya , Dilek Dilli , Yasin Sarikaya , Hasan Akduman , Rumeysa Citli , Utku A. Orun , Mehmet Tasar , Aysegul Zenciroglu
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引用次数: 0

Abstract

Background

Newborns with critical congenital heart disease (CCHD) with increased pulmonary blood flow (PBF) are at high risk for congestive heart failure. In this study, we aimed to evaluate the presence and degree of pulmonary edema in newborns with CCHD using lung ultrasound (LUS) during the perioperative period.

Methods

Prospective clinical trial, 44 newborn patients with CCHD were evaluated in this prospective clinical trial. LUS was repeatedly performed to determine the course of pulmonary edema during the perioperative period. LUS was performed simultaneously with chest radiography (CXR), which was the main part of patient management. The primary outcome of this study was to identify whether a correlation existed between LUS and CXR findings. The secondary outcomes were to determine the relationship between LUS and the need for respiratory support, diuretic use, vasoactive inotropic score (VIS), and pro-B-type natriuretic peptide (pro-BNP) levels during the perioperative period.

Results

The mean gestational age of the patients was 38.3 ± 1.7 weeks, with a mean birth weight of 3026 ± 432 g. In the preoperative period, both LUS and CXR images were consistent with clinical signs of pulmonary edema. On the first postoperative day, pulmonary edema increased compared to the preoperative period but gradually decreased by the 6th day of surgery (p < 0.05). Positive correlations were observed between the LUS and CXR findings at all study points (p < 0.05). The LUS findings exhibited trends parallel to those of VIS, serum pro-BNP levels, need for respiratory support, and diuretic requirements. As expected, these trends were more pronounced in CCHDs where PBF increased.

Conclusion

In CCHD, serial lung ultrasound (LUS) assessments, particularly in cases with increased PBF, can provide valuable guidance for managing patients during the perioperative period.
肺部超声评估患有严重先天性心脏病的新生儿肺水肿。
背景:患有严重先天性心脏病(CCHD)且肺血流(PBF)增加的新生儿是充血性心力衰竭的高危人群。在这项研究中,我们的目的是在围手术期使用肺超声(LUS)评估 CCHD 新生儿肺水肿的存在和程度:这项前瞻性临床试验共评估了 44 名 CCHD 新生儿患者。在围手术期反复进行 LUS,以确定肺水肿的进程。LUS 与胸片 (CXR) 同时进行,后者是患者管理的主要部分。本研究的主要结果是确定 LUS 和 CXR 结果之间是否存在相关性。次要结果是确定 LUS 与围手术期呼吸支持需求、利尿剂使用、血管活性肌力评分(VIS)和前 B 型钠尿肽(pro-BNP)水平之间的关系:患者的平均胎龄为 38.3 ± 1.7 周,平均出生体重为 3026 ± 432 克。术前,LUS 和 CXR 图像与肺水肿的临床表现一致。术后第一天,肺水肿较术前加重,但在术后第 6 天逐渐减轻(P在慢性阻塞性肺疾病患者中,连续的肺超声(LUS)评估,尤其是在 PBF 增加的病例中,可为围手术期患者的管理提供有价值的指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
170
审稿时长
48 days
期刊介绍: Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.
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