Perioperative Transthoracic Lung Ultrasound for Assessment of Pulmonary Outcome in Adolescent Idiopathic Scoliosis Patients: Prospective, Observational Pilot Study

• Published in: Scientific reports 2019-11, Vol.9 (1), p.17840-9, Article 17840
• Main Authors: Chang, Hae Wone, Won, Young Ju, Lim, Byung Gun, Suh, Seung Woo, Lee, Dong Kyu, Lee, Il Ok, Ji, Sul Gi, Kim, HeeZoo
• Format: Article
• Language: English
• Subjects: 692/308/2779/109/2425; 692/308/409; Adolescent; Anesthesia; Blood gas analysis; Blood pressure; Female; Humanities and Social Sciences; Humans; Hypoxia; Lung - diagnostic imaging; Lung - physiology; Male; Mechanical ventilation; Monitoring, Intraoperative - methods; multidisciplinary; Multiple regression analysis; Orthopedic Procedures - adverse effects; Oxygen; Oxygenation; Patients; Pleural effusion; Pneumothorax; Pneumothorax - diagnostic imaging; Pneumothorax - prevention & control; Postoperative Complications - diagnostic imaging; Postoperative Complications - prevention & control; Pulmonary Gas Exchange; Respiration, Artificial - adverse effects; Respiratory therapy; Science; Science (multidisciplinary); Scoliosis; Scoliosis - surgery; Surgery; Ultrasonic imaging; Ultrasonography - methods; Ultrasound; Variance analysis; Ventilation; Young Adult
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-54437-y

The purpose of study was to evaluate the perioperative lung ultrasound findings of patients undergoing scoliosis correction. LUS examination was performed examined three 3 times for each patient: 20 min after starting mechanical ventilation of the lungs(preoperative), after surgery when the patient was placed in the supine position(postoperative), and 20 min after arrival in the post-anaesthesia care unit. Arterial blood gas analyses, mechanical ventilation parameters, peripheral oxygen saturation(SpO2) were also checked. Twenty-six patients completed the study. The changes of LUS score(20 min) was significantly negatively correlated with the partial pressure of arterial oxygen(PaO2)/fraction of inspired oxygen(FiO2) ratio change(P = 0.039, r = −0.40). The change in mean convex side LUS score was significantly greater than that of the concave side as determined by two-factor repeated measures analysis of variance(p = 0.001). Multiple regression analysis revealed perioperative LUS change was the significant factor related to the oxygen index change (p = 0.042). One case of pneumothorax was diagnosed and pleural thickening more than 5 mm was detected in 8 patients and five patients of those were diagnosed pleural effusion and performed thoracentesis after surgery. Postoperative increase of LUS score was related with deteriorating of oxygenation at one day after surgery, and it suggests that lung ultrasound allows prediction of postoperative hypoxia and facilitates the diagnosis of pulmonary complications at operation room in AIS patients.