The usefulness of respiratory ultrasound assessment for modifying the physiotherapeutic algorithm in children after congenital heart defect surgeries
Background: The aim of the study was to assess the effectiveness and the possible use of diagnostic transthoracic ultrasound of the respiratory tract to qualify patients for therapy and to monitor the effectiveness of physiotherapy in children after cardiac surgeries. Materials and methods: A tota...
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2019-03-01
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| Series: | Journal of Ultrasonography |
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| Online Access: | http://jultrason.pl/index.php/issues/volume-19-no-76/the-usefulness-of-respiratory-ultrasound-assessment-for-modifying-the-physiotherapeutic-algorithm-in-children-after-congenital-heart-defect-surgeries?aid=690 |
| Summary: | Background: The aim of the study was to assess the effectiveness and the possible use
of diagnostic transthoracic ultrasound of the respiratory tract to qualify patients for therapy and to monitor the effectiveness of physiotherapy in children after cardiac surgeries.
Materials and methods: A total of 103 patients aged between 1 and 12 months who underwent a series of congenital heart surgeries using cardiopulmonary bypass were qualified
for the prospective analysis. Point-of-care respiratory ultrasound imaging was performed
according to a tailored protocol during the patient’s stay in the intensive care unit. In order
to evaluate the method, the obtained findings were subject to comparative analysis against
the available radiographic findings with a division into sectors. Results: The comparative
analysis of ultrasonographic and radiographic findings with a division into sectors showed
the highest concordance rate (89.6%) for S1L (the apex of the left lung) and the lowest
concordance rate (57.0%) for S2L (pericardial region). The highest discordance rate, i.e.
when a lesion was detected in radiography (X-ray = 1), but was not confirmed by ultrasound (US = 0), was reported for sectors S1P (right lung apex) – 26.1%, and S2L – 40.0%,
whereas the lowest discordance rate was reported for S1L – 7.0%. The highest discordance
rate, i.e. when a lesion was shown in ultrasound (US = 1), but was not confirmed by
radiography (X-ray = 0) was reported for S3P (the base of the right lung) and S3L (base
of the right lung) – 28.3% and 26.1%, respectively. Conclusions: The author’s protocol for
ultrasonographic assessment of the respiratory tract is an optimal tool for determining
therapeutic goals, as well as for the assessment of the efficacy of pulmonary physiotherapy.
The diagnostic value of ultrasonographic assessment of the respiratory tract and standard
radiography in the study group depends on the location of the investigated lung segment. |
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| ISSN: | 2084-8404 2451-070X |