Lung ultrasound in patients after cardiothoracic surgery : Early detection of clinically relevant postoperative pulmonary complications

Parlevliet, K.L. (Krista Lucia) (2016) Lung ultrasound in patients after cardiothoracic surgery : Early detection of clinically relevant postoperative pulmonary complications. thesis, Medicine.

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Abstract

Background: Clinically relevant postoperative pulmonary complications are common after cardiothoracic surgery and associated with adverse outcomes. Early detection is important for early interventions and monitoring. The sensitivity of chest X-rays (CXRs) and chest auscultation (CA) is limited. CXRs have multiple limitations, including radiation exposure. Lung ultrasound (LUS) is emerging as a sensitive diagnostic tool for pulmonary pathology within the intensive care unit (ICU). In literature little is known about the value of LUS in the cardiothoracic surgery population. The primary aim of this study is to assess whether clinically relevant PPCs are earlier detected with routine LUS compared to routine CXR and CA in patients after cardiothoracic surgery. Method: This is a prospective observational single center study. LUS was performed three times on the same days as routine CXR: day of surgery (day 0), two and three days after surgery). CA, CXR and LUS findings on day 0, 2 and 3, were compared to clinically relevant PPCs identified by treating ICU-physicians on day 0, 2 or 3. Forty cardiothoracic surgical patients were included. Results: 15 clinically relevant PPCs were identified in 14 patients (35%). CA detected 1 clinically relevant PPC (6.7%), CXR 6 (40%) and LUS 11 (73.3%). Clinically relevant PPCs were earlier detected with LUS. Conclusion: LUS detects clinically relevant PPCs earlier than CXR. Our findings suggest that LUS could be a reliable alternative to CXR. These results must be confirmed in a larger study. Keywords: lung ultrasound, cardiothoracic surgery, postoperative pulmonary complications, early detection, chest x-ray, chest auscultation, intensive care unit, cardiac surgery.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor: and Cornet, Dr. A.D. internist-intensivist. and Hospital: Medisch Spectrum Twente, Enschede and Department: Intensive Care Center.
Supervisor name:	Supervisor: and Tuinman, Dr. P.R. internist-intensivist. and Hospital: VU University Medical Center, Amsterdam. and Department: Intensive Care Medicine
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:06
Last Modified:	25 Jun 2020 11:06
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2598

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