Characteristics of changes in postoperative early lung ultrasound imaging in pediatric patients undergoing living-related liver transplantation / 中华麻醉学杂志

ABSTRACT

Objective:To determine the characteristics of changes in postoperative early lung ultrasound imaging in pediatric patients undergoing living-related liver transplantation.Methods:A total of 96 pediatric patients of both sexes, aged 3-24 months, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with Child-Pugh grade B or C, scheduled for elective living-related liver transplantation performed with the piggy back technique, were selected.At 24 h before surgery (T 0), at 24 h after surgery (T 1) and at 72 h after surgery (T 2), the condition of lung ultrasound was recorded.Ultrasound examination was performed using Color Doppler ultrasound diagnostic instrument with a linear array probe (frequency 7-13 MHz). The lung was divided into 12 areas, and each area of both lungs was scanned successively.The lung ultrasound score in each area was recorded.The results with the highest scores were considered as the ultrasound results of this area.The general conditions of the pediatric patients were recorded and the fluid volume (input minus output) per kilogram per minute was calculated. Results:Compared with the values at T 0, the scores for lung consolidation and the pulmonary edema in lateral area were significantly increased at T 1, and the scores for lung consolidation, pulmonary edema and pleural effusion in posterior area and total score for lung consolidation, pulmonary edema and pleural effusion in each area were increased at T 1, 2 ( P<0.05). Compared with the values at T 1, the scores for lung consolidation in posterior area and total score for lung consolidation in each area were significantly decreased, and the scores for pulmonary edema in lateral and posterior areas and total score for pulmonary edema in each area were decreased at T 2 ( P<0.05), and no significant change was found in the lung ultrasound scores in anterior area at each time point ( P>0.05). Compared with the values in anterior area, the scores for lung consolidation at each time point were significantly increased, scores for pulmonary edema at T 1, 2 were increased, and score for pleural effusion at T 1 was increased in lateral area, and scores for lung consolidation, pulmonary edema and pleural effusion at each time point were increased in posterior area ( P<0.05). Compared with the values in lateral area, the scores for lung consolidation, pulmonary edema and pleural effusion at each time point were significantly increased in posterior area ( P<0.05). Conclusion:Lung consolidation, pulmonary edema and pleural effusion tend to occur in the lateral and posterior areas of the lung at 1 day after living-related liver transplantation, and the complications are severer in posterior areas.The lung consolidation in the posterior region is alleviated than that in the anterior area, and the pulmonary edema in the lateral and posterior areas is alleviated than that in the anterior area.However, all of these indexes don′t return back to their preoperative status.