Lung ultrasound as a diagnostic tool for pulmonary consolidation and atelectasis after cardiac surgery.

Abstract

Background: Pulmonary consolidation and atelectasis (PCA) are common complications following cardiac surgery, significantly impacting patient prognosis. This study aims to explore the diagnostic and prognostic applications of lung ultrasound (LUS) for PCA.

Methods: This study enrolled patients undergoing cardiac surgery who received LUS, chest X-ray (CXR), and chest computed tomography (CT) within 24 hours postoperatively. Using CT as the gold standard for PCA diagnosis, we evaluated the diagnostic accuracy of LUS and CXR. Additionally, we analyzed the correlation between the lung ultrasound score (LUSS), quantitative lung ventilation parameters, and clinical outcomes.

Results: Among 66 patients, 60 were diagnosed with PCA by CT. LUS demonstrated superior diagnostic accuracy compared to CXR [the area under the curve (AUC) =0.808 vs. 0.608]. The agreement between LUS and CT findings was moderate (Kappa =0.574). LUSS showed significant correlations with lung infiltration (r=0.398, P<0.001), lung collapse (r=0.328, P=0.007), PCA severity (r=0.606, P<0.001), CT score (r=0.401, P<0.001), and intensive care unit (ICU) stay (r=0.347, P=0.004). However, no significant correlations were observed between LUSS and duration of mechanical ventilation (r=0.159, P=0.20) or total hospital stay (r=0.144, P=0.25).

Conclusions: LUS exhibits higher diagnostic accuracy for PCA compared to CXR. While LUSS correlates with ICU stay, it does not influence the duration of mechanical ventilation or total hospital stay.