EVLW by Lung Ultrasound to Predict Short-Term Post Operative Outcomes in Pediatric Cardiac Surgery - A Prospective Observational Study.

Abstract

Background: Extravascular lung water (EVLW) in children undergoing cardiac surgery may affect the outcomes after surgery. The study aimed to evaluate if extravascular lung water assessed by ultrasound could serve as a predictor of short-term postoperative outcomes in pediatric cardiac surgery.

Material and methods: This is a prospective observational study conducted at a tertiary care facility involving children aged 6 months to 12 years who were scheduled for cardiac surgery. A lung ultrasound assessment was carried out before the operation (T0), immediately after the surgery (T1), 6 to 8 hours after surgery (T2), and 18 to 24 hours postoperatively (T3). A score was assigned based on the presence of extravascular lung water indicated by B lines. Pearson's correlation analysis was performed to examine the relationship between the lung ultrasound score of extravascular lung water and the duration of mechanical ventilation and the length of stay in the intensive care unit, with fluid balance, inotrope score, and oxygenation status being analyzed secondarily.

Results: The EVLW score demonstrated a positive relationship with the duration of mechanical ventilation across all time points, with correlation coefficients of r = 0.56 at T0, r = 0.70 at T1, r = 0.40 at T2, and r = 0.52 at T3. The most pronounced correlation occurred at T1, where r = 0.7 was observed. A moderate positive correlation with the duration of ICU stay was noted at the time points T0, T1, and T3. The EVLW score at T1 proved to be significant in linear regression analysis for prediction of both the duration of mechanical ventilation and the length of stay in the ICU.

Conclusions: The EVLW score measured at T1, which is immediately after surgery, can serve as an indicator of short-term postoperative outcomes in pediatric cardiac surgery related to the duration of mechanical ventilation.