Bedside ultrasound better than fluoroscopy for post-op pediatric cardiopulmonary patients
Children recovering from heart surgery in intensive care are better imaged for diaphragmatic paralysis with bedside chest ultrasound than with bedside fluoroscopy, according to a study published online Oct. 28 in Pediatric Critical Care Medicine.
Researchers from the Autonomous University of Barcelona in Spain and Children’s Hospital of Pittsburgh in Pennsylvania reviewed the cases of 26 post-op pediatric ICU patients (median age five months, range 16 days to 14 years) who showed signs of abnormal diaphragmatic motion.
Electromyography confirmed the diagnosis of diaphragmatic paralysis in 20 of them.
Comparing the two modalities as administered and interpreted by two different pediatric intensivists, the researchers found that bedside chest ultrasound outperformed fluoroscopy in both sensitivity (approximately 93 percent vs. 87 percent) and specificity (approximately 93 percent vs. 83 percent).
The overall occurrence rate of abnormal diaphragmatic motion during the study period was 7.5 percent.
“Chest ultrasound performed by intensivists is a valid tool for the diagnosis of diaphragmatic paralysis,” the study authors conclude. “Chest ultrasound should be routinely used after pediatric heart surgery given its reliability, reproducibility, availability and safety.”
Diaphragmatic dysfunction is common in patients who have had cardiac surgery, according to the literature. The condition’s results vary from observable but asymptomatic abnormalities to severe pulmonary dysfunction that may require prolonged mechanical ventilation.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.