Department of Anesthesiology and Intensive Care, Saint Petersburg State University Hospital, St. Petersburg, Russian Federation.
Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russian Federation.
J Cardiothorac Vasc Anesth. 2020 Nov;34(11):3113-3124. doi: 10.1053/j.jvca.2020.01.032. Epub 2020 Jan 23.
Pulmonary complications are common after cardiac surgery and are closely related to postoperative heart failure and adverse outcomes. Lung ultrasonography (LUS) is currently a widely accepted diagnostic approach with well-established methodology, nomenclature, accuracy, and prognostic value in numerous clinical conditions. The advantages of LUS are universally recognized and include bedside applicability, high diagnostic sensitivity and reproducibility, no radiation exposure, and low cost. However, routine perioperative ultrasonography during cardiac surgery generally is limited to echocardiography, diagnosis of pleural effusion, and as a diagnostic tool for postoperative complications in different organs, and few studies have explored the clinical outcomes in relation to LUS among cardiac patients. This narrative review presents the clinical evidence regarding LUS application in intensive care and during the perioperative period for cardiac surgery. Furthermore, this review describes the methodology and the diagnostic and prognostic accuracies of LUS. A summary of ongoing clinical trials evaluating the clinical outcomes related to LUS also is provided. Finally, this review discusses the rationale for upcoming clinical research regarding whether routine use of LUS can modify current intensive care practice and potentially affect the clinical outcomes after cardiac surgery.
心脏手术后常见肺部并发症，与术后心力衰竭和不良预后密切相关。肺部超声（LUS）目前是一种广泛认可的诊断方法，具有完善的方法学、命名法、准确性和在许多临床情况下的预后价值。LUS 的优点被普遍认可，包括床边适用性、高诊断灵敏度和可重复性、无辐射暴露和低成本。然而，心脏手术中的常规围手术期超声通常仅限于超声心动图、胸腔积液的诊断以及作为不同器官术后并发症的诊断工具，很少有研究探讨与心脏患者 LUS 相关的临床结局。本综述介绍了 LUS 在重症监护和心脏手术后围手术期的临床应用证据。此外，本综述描述了 LUS 的方法学以及诊断和预后准确性。还提供了正在评估与 LUS 相关的临床结局的临床试验的概述。最后，本综述讨论了有关是否常规使用 LUS 是否可以改变当前重症监护实践并可能影响心脏手术后临床结局的未来临床研究的基本原理。
