Diwakar Anitha, Punetha Pankaj, Kamat Anuradha, Chalam Kolli S
Department of Anaesthesiology, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India.
Ann Card Anaesth. 2025 Jul 1;28(3):305-309. doi: 10.4103/aca.aca_230_24. Epub 2025 Jul 8.
Extravascular lung water (EVLW) in children undergoing cardiac surgery may affect the outcomes after surgery. The study aimed to evaluate if extravascular lung water assessed by ultrasound could serve as a predictor of short-term postoperative outcomes in pediatric cardiac surgery.
This is a prospective observational study conducted at a tertiary care facility involving children aged 6 months to 12 years who were scheduled for cardiac surgery. A lung ultrasound assessment was carried out before the operation (T0), immediately after the surgery (T1), 6 to 8 hours after surgery (T2), and 18 to 24 hours postoperatively (T3). A score was assigned based on the presence of extravascular lung water indicated by B lines. Pearson's correlation analysis was performed to examine the relationship between the lung ultrasound score of extravascular lung water and the duration of mechanical ventilation and the length of stay in the intensive care unit, with fluid balance, inotrope score, and oxygenation status being analyzed secondarily.
The EVLW score demonstrated a positive relationship with the duration of mechanical ventilation across all time points, with correlation coefficients of r = 0.56 at T0, r = 0.70 at T1, r = 0.40 at T2, and r = 0.52 at T3. The most pronounced correlation occurred at T1, where r = 0.7 was observed. A moderate positive correlation with the duration of ICU stay was noted at the time points T0, T1, and T3. The EVLW score at T1 proved to be significant in linear regression analysis for prediction of both the duration of mechanical ventilation and the length of stay in the ICU.
The EVLW score measured at T1, which is immediately after surgery, can serve as an indicator of short-term postoperative outcomes in pediatric cardiac surgery related to the duration of mechanical ventilation.
接受心脏手术的儿童血管外肺水（EVLW）可能会影响术后结局。本研究旨在评估超声评估的血管外肺水是否可作为小儿心脏手术短期术后结局的预测指标。
这是一项在三级医疗机构进行的前瞻性观察性研究，纳入了计划接受心脏手术的6个月至12岁儿童。在手术前（T0）、手术后即刻（T1）、术后6至8小时（T2）和术后18至24小时（T3）进行肺部超声评估。根据B线提示的血管外肺水情况进行评分。采用Pearson相关分析来检验血管外肺水的肺部超声评分与机械通气时间及重症监护病房住院时间之间的关系，同时对液体平衡、血管活性药物评分和氧合状态进行次要分析。
在所有时间点，EVLW评分与机械通气时间均呈正相关，T0时相关系数r = 0.56，T1时r = 0.70，T2时r = 0.40，T3时r = 0.52。最显著的相关性出现在T1，r = 0.7。在T0、T1和T3时间点，观察到与重症监护病房住院时间呈中度正相关。T1时的EVLW评分在预测机械通气时间和重症监护病房住院时间的线性回归分析中具有显著意义。
术后即刻测量的T1时的EVLW评分可作为小儿心脏手术中与机械通气时间相关的短期术后结局指标。
