Value of pulmonary ultrasound in extracorporeal membrane oxygenation in children with severe acute respiratory distress syndrome / 中华超声影像学杂志

ABSTRACT

Objective To explore the application value of pulmonary ultrasound for the treatment of severe acute respiratory distress syndrome in children with extracorporeal membrane oxygenation( ECM O ) . Methods Seven children with severe acute respiratory distress syndrome ( ARDS ) w ho were treated with ECM O in the PICU ward of Hunan Children Hospital from August 2018 to M arch 2019 underwent pulmonary ultrasound before treated with ECM O , after each bronchoscopy and lavage , before ECM O withdrawal ,and within 24 hours after ECM O withdrawal . Performance of pulmonary ultrasound and clinical data were retrospectively reviewed . Results Seven patients treated with ECM O for 11 .5( 3－27) days ,and 1 patient underwent ECM O transport . Six ( 86 .7% ) patients were successfully weaned from ECM O ,and 1 ( 14 .2% ) patient failed to exit ECM O successfully . Four( 57 .1% ) patients were discharged from hospital , and 3( 42 .8% ) patients eventually died . In various diagnostic signs of pulmonary ultrasound were detected in 7 patients ,including pulmonary edema ( 7 cases ) ,lung consolidation ( 5 cases ) ,followed by pleural effusion ( 4 cases) ,atelectasis ( 3 cases) and pneumothorax ( 3 cases ) . Pulmonary ultrasound showed that the lungs were re‐expanded and suggested that the child could attempt to evacuate the ECM O . Conclusions Pulmonary ultrasound can comprehensively evaluate the various lung lesions in children with ECM O treatment ,and can dynamically monitor the process of lung recruitment in real time ,providing a reference for guiding the evacuation of ECM O .