Lung ultrasound for early diagnosis of postoperative need for ventilatory support: a prospective observational study
Pulmonary complications have a significant impact on morbidity and mortality in patients after major surgery. We conducted a prospective observational study in Dijon and Pavia to evaluate whether lung ultrasound could be used as a predictive marker for postoperative ventilatory support in high-risk surgical patients. We included 109 patients admitted to the intensive care unit while having mechanical ventilation of the lungs following major surgery.
Patients with a lung ultrasound score ≥ 10 had a lower PaO2 /FiO2 ratio, and needed more postoperative ventilatory support, than patients with lung ultrasound score < 10. The presence of ≥ 2 areas of consolidated lung was associated with a lower PaO2/FiO2 ratio, postoperative ventilatory support, longer intensive care stay and episodes of ventilator-associated pneumonia requiring antibiotics.
Our results suggest that at intensive care unit admission, lung ultrasound scoring and detection of atelectasis can predict postoperative pulmonary outcomes after major visceral surgery, and could enhance bed-side decision making.
Anaesthesia. 2019 Sep 23. doi: 10.1111/anae.14859.