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Combined Echocardiography and Lung Ultrasound for Extubation Outcome Prediction in Children after Cardiac Surgery

Congenital Heart Disease 2022年第3期17卷 231-244页

作者： Muzi Li Hong Meng Liang Zhang Yuzi Zhou Chao Liang Zhiling Luo Hao Wang Department of Echocardiography Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Pediatric Cardiac Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Pediatric Intensive Care Unit Department of Pediatric Cardiac SurgeryFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Echocardiography Fuwai Yunnan Cardiovascular HospitalKunmingChina

Background:Children are at risk of extubation failure after congenital heart disease *** cases should be identified to avoid possible adverse consequences of failed *** study aimed to identify ultrasound predictors of successful extubation in children who underwent cardiac ***:Children aged 3 months to 6 years who underwent cardiac surgery(if they were intubated for>6 h and underwent a spontaneous breathing trial)were included in this ***:We included 83 children who underwent surgery for congenital heart *** echocardiography and lung ultrasound were performed immediately before spontaneous breathing *** spontaneous breathing trial completion,respiratory parameters,including arterial blood gas analysis and frequency-to-tidal volume ratio,were similarly *** outcome assessment,all children were followed up for 48 h after *** successfully extubated 57 children(68.7%).These children were significantly older and weighed more but had shorter aortic cross-clamp and cardiopulmonary bypass *** who could not be weaned or extubated had prolonged total mechanical ventilation and pediatric intensive care unit *** the multivariate regression analysis,a lung ultrasound score≥12 and ejection fraction≥40%immediately before spontaneous breathing trials were the only independent predictors of successful *** combined,the lung ultrasound score and an ejection fraction≥40%showed a better diagnostic performance than every other isolated variable(lung ultrasound,N-terminal-pro-B-type natriuretic peptide,and frequency-to-tidal volume ratio).Conclusions:The combination of lung ultrasound and transthoracic echocardiography immediately before the spontaneous breathing trial effectively predicts extubation outcomes in children after cardiac surgery.

关键词： Lung echocardiography intensive care units pediatric airway extubation ventilator weaning pro-brain natriuretic peptide

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