Rucham Moshe, Lior Yotam, Fuchs Lior, Gruenbaum Benjamin F, Acker Asaf, Zlotnik Alexander, Brotfain Evgeni
Division of Anesthesiology and Critical Care, Soroka University Medical Center, Beer Sheva 8453227, Israel.
Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel.
J Clin Med. 2024 Nov 24;13(23):7098. doi: 10.3390/jcm13237098.
For patients undergoing abdominal surgery, postoperative pulmonary complications (PPCs) are a major source of morbidity and mortality. The use of point-of-care ultrasonography (POCUS), and specifically POCUS of the lungs, has seen many advancements in recent years. We hypothesize that perioperative lung ultrasonography can be used as a predictor for PPCs. In a Single, 1000 beds, trauma level I medical center, patients presenting for elective intra-abdominal surgery with no severe pulmonary or cardiac diseases were evaluated preoperatively with a standardized 12-point lung ultrasound exam. A second identical exam was performed after surgery in the post-anesthesia care unit. PPCs were also documented. All lung ultrasound exams were presented to a blinded researcher and a lung ultrasound score (LUS) was calculated. Statistical analysis comparing pre- and postoperative LUS and PPC scores were performed. A total of 61 patients were evaluated. The pre-surgery median LUS was 0 (in the range of 0-6) and the post-surgery median LUS was 3 (in the range of 0-14). The pre- to postsurgical LUS delta was 3.4 (standard deviation of 3.3). A postoperative LUS of 6 or more was defined as "high." A High LUS did not correlate with prolonged post-anesthesia care unit or hospital stay, prolonged oxygen support, or number of desaturation events. For elective abdominal surgery in relatively healthy patients, preoperative LUS usually begins at a normal level and becomes worse after general anesthesia. However, this difference in LUS is not significantly associated with clinically relevant postoperative pulmonary complications such as prolonged oxygen therapy, pneumonia, and noninvasive or invasive mechanical ventilation. Trial registration: Clinicaltrials.gov identifier: NCT05502926. Summary: This paper explores the use of point-of-care ultrasonography as a predictor for postoperative pulmonary complications. The findings suggest that while the lung ultrasound score worsens with general anesthesia, the differences are not significantly associated with postoperative pulmonary complications.
对于接受腹部手术的患者，术后肺部并发症（PPCs）是发病和死亡的主要原因。近年来，床旁超声检查（POCUS），特别是肺部的POCUS有了许多进展。我们假设围手术期肺部超声检查可作为PPCs的预测指标。在一家拥有1000张床位的一级创伤医疗中心，对择期进行腹腔内手术且无严重肺部或心脏疾病的患者在术前进行标准化的12点肺部超声检查评估。术后在麻醉后护理单元进行第二次相同的检查。同时记录PPCs情况。所有肺部超声检查结果提交给一位不知情的研究人员，并计算肺部超声评分（LUS）。对术前和术后的LUS及PPC评分进行统计分析比较。共评估了61例患者。术前LUS中位数为0（范围0 - 6），术后LUS中位数为3（范围0 - 14）。术前至术后LUS差值为3.4（标准差3.3）。术后LUS≥6被定义为“高”。高LUS与麻醉后护理单元或住院时间延长、吸氧时间延长或血氧饱和度下降事件数量无关。对于相对健康的患者进行择期腹部手术，术前LUS通常处于正常水平，全身麻醉后会变差。然而，LUS的这种差异与延长吸氧治疗、肺炎以及无创或有创机械通气等临床相关的术后肺部并发症并无显著关联。试验注册：Clinicaltrials.gov标识符：NCT05502926。总结：本文探讨了床旁超声检查作为术后肺部并发症预测指标的应用。研究结果表明，虽然肺部超声评分在全身麻醉后变差，但差异与术后肺部并发症并无显著关联。
