Usefulness of Lung Ultrasonography for Diagnosis of Pneumonia After Major Cardiac Surgery: a Pilot Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Pneumonia
- Sponsor
- Groupe Hospitalier Pitie-Salpetriere
- Enrollment
- 51
- Primary Endpoint
- Final diagnosis of pneumonia
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Diagnosis of pneumonia remains difficult in intensive care unit (ICU), notably after cardiac surgery. Lung ultrasonography (LUS) has been successfully used for diagnosis of pneumonia, but its usefulness and reliability was never evaluated after cardiac surgery. This study investigates the clinical relevance of LUS for pneumonia diagnoses in cardiac ICU.
Investigators
Adrien Bouglé
Principal Investigator
Groupe Hospitalier Pitie-Salpetriere
Eligibility Criteria
Inclusion Criteria
- •Cardiac surgery with sternotomy and cardio-pulmonary bypass (CPB) less than 3 days before
- •At least one component suggestive of ARF:
- •If mechanical ventilation, a PaO2 / FiO2 ratio \<200, or failure of weaning (failure of spontaneous ventilation test, re-intubation in the first 24 hours), or need for non-invasive ventilation immediately after extubation,
- •If spontaneous ventilation: clinical signs of acute respiratory distress (dyspnea at least exertion, cyanosis, polypnea\> 25/min, upper or intercostal swallowing, abdominal swing ...), SpO2 \< 90% or PaO2 \<60 mmHg despite oxygen therapy ≥ 3L/min.
Exclusion Criteria
- •Minor patients
- •Pregnancy
- •Sleep apnea syndrome
- •Participation refusal
Outcomes
Primary Outcomes
Final diagnosis of pneumonia
Time Frame: During the 72 hours following surgery
Pneumonia or excluded pneumonia, was determined by consensus of 3 investigators, after an independent post hoc review of the medical records. Pneumonia diagnosis was based on concordance of clinical and radiological criteria (≥ 2 criteria including fever\> 38.5 ° C or T \<36 ° C, leukocytosis\> 10 \^ 9 / L or leukopenia \<4.10 \^ 8 / L, purulent tracheal secretions and the appearance or persistence of an infiltrate on the CXR). It should be confirmed by culture of a respiratory specimen: protected distal sampling with a threshold of significance ≥ 10 \^ 3 colony forming unit/mL or bronchoalveolar lavage with a threshold of significance ≥ 10 \^ 4 CFU/mL.