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(ECMO).@*Methods@#Seven children with severe acute respiratory distress syndrome (ARDS) who were treated with ECMO in the PICU ward of Hunan Children Hospital from August 2018 to March 2019 underwent pulmonary ultrasound before treated with ECMO, after each bronchoscopy and lavage, before ECMO withdrawal, and within 24 hours after ECMO withdrawal. Performance of pulmonary ultrasound and clinical data were retrospectively reviewed.@*Results@#Seven patients treated with ECMO for 11.5(3-27)days, and 1 patient underwent ECMO transport. Six (86.7%) patients were successfully weaned from ECMO, and 1 (14.2%) patient failed to exit ECMO 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 ECMO.@*Conclusions@#Pulmonary ultrasound can comprehensively evaluate the various lung lesions in children with ECMO treatment, and can dynamically monitor the process of lung recruitment in real time, providing a reference for guiding the evacuation of ECMO.