Lung Ultrasonography After Major Cardiac Surgery

Groupe Hospitalier Pitie-Salpetriere51 enrolled

Overview

Diagnosis of pneumonia remains difficult in intensive care unit (ICU), notably after cardiac surgery. Lung ultrasonography (LUS) has been successfully used for diagnosis of pneumonia, but its usefulness and reliability was never evaluated after cardiac surgery. This study investigates the clinical relevance of LUS for pneumonia diagnoses in cardiac ICU.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Pneumonia Cardio/Pulm: Respiratory Failure Cardiopulmonary Bypass

Interventions

Lung UltrasoundDIAGNOSTIC_TEST

Eligibility

Sex: ALLMin age: 18 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Cardiac surgery with sternotomy and cardio-pulmonary bypass (CPB) less than 3 days before * At least one component suggestive of ARF: * If mechanical ventilation, a PaO2 / FiO2 ratio \<200, or failure of weaning (failure of spontaneous ventilation test, re-intubation in the first 24 hours), or need for non-invasive ventilation immediately after extubation, * If spontaneous ventilation: clinical signs of acute respiratory distress (dyspnea at least exertion, cyanosis, polypnea\> 25/min, upper or intercostal swallowing, abdominal swing ...), SpO2 \< 90% or PaO2 \<60 mmHg despite oxygen therapy ≥ 3L/min. Exclusion Criteria: * Minor patients * Pregnancy * Sleep apnea syndrome * Participation refusal

Outcomes

Primary Outcomes

Final diagnosis of pneumonia

Pneumonia or excluded pneumonia, was determined by consensus of 3 investigators, after an independent post hoc review of the medical records. Pneumonia diagnosis was based on concordance of clinical and radiological criteria (≥ 2 criteria including fever\> 38.5 ° C or T \<36 ° C, leukocytosis\> 10 \^ 9 / L or leukopenia \<4.10 \^ 8 / L, purulent tracheal secretions and the appearance or persistence of an infiltrate on the CXR). It should be confirmed by culture of a respiratory specimen: protected distal sampling with a threshold of significance ≥ 10 \^ 3 colony forming unit/mL or bronchoalveolar lavage with a threshold of significance ≥ 10 \^ 4 CFU/mL.

Time frame: During the 72 hours following surgery

Data from ClinicalTrials.gov

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