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Bedside sonography assessment of extravascular lung water increase after major pulmonary resection in non-small cell lung cancer patients

  
@article{JTD22490,
	author = {Lucio Cagini and Marco Andolfi and Cecilia Becattini and Maria Giovanna Ranalli and Francesco Bartolucci and Alessandra Mancuso and Jacopo Vannucci and Giancarlo Agnelli and Francesco Puma},
	title = {Bedside sonography assessment of extravascular lung water increase after major pulmonary resection in non-small cell lung cancer patients},
	journal = {Journal of Thoracic Disease},
	volume = {10},
	number = {7},
	year = {2018},
	keywords = {},
	abstract = {Background: Extra vascular lung water (EVLW) following pulmonary resection increases due to fluid infusion and rises in capillary surface and permeability of the alveolar capillary membranes. EVLW increase clinically correlates to pulmonary oedema and it may generate impairments of gas exchanges and acute lung injury. An early and reliable assessment of postoperative EVLW, especially following major pulmonary resection, is useful in terms of reducing the risk of postoperative complications. The currently used methods, though satisfying these criteria, tend to be invasive and cumbersome and these factors might limit its use. The presence and burden of EVLW has been reported to correlate with sonographic B-line artefacts (BLA) assessed by lung ultrasound (LUS). This observational study investigated if bedside LUS could detect EVLW increases after major pulmonary resection. Due to the clinical association between EVLW increase and impairment of gas exchange, secondary aims of the study included investigating for associations between any observed EVLW increases and both respiratory ratio (PaO2/FiO2) and fluid retention, measured by brain natriuretic peptide (BNP). 
Methods: Overall, 74 major pulmonary resection patients underwent bedside LUS before surgery and at postoperative days 1 and 4, in the inviolate hemithorax which were divided into four quadrants. BLA were counted with a four-level method. The respiratory ratio PaO2/FiO2 and fluid retention were both assessed. 
Results: BLA resulted being increased at postoperative day 1 (OR 9.25; 95% CI, 5.28–16.20; P},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/22490}
}