LUNG ULTRASOUND SCORE PREDICTS CHANGES IN ECHOCARDIOGRAPHIC PARAMETERS AFTER THE MANAGEMENT OF CHILDREN WITH CONGENITAL HEART DISEASE AND PULMONARY OVERFLOW | ||
| Al-Azhar Journal of Pediatrics | ||
| Article 8, Volume 26, Issue 3, July 2023, Pages 3528-3542 PDF (228.4 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/azjp.2023.314978 | ||
| Abstract | ||
| Background: Pulmonary overflow (PO) is a common finding in left-to-right shunting congenital heart diseases (CHD). B-line artifacts are seen on lung ultrasound in the presence of extravascular lung water. Objective: We aimed to investigate the feasibility of lung ultrasound (LUS) to monitor changes in extravascular lung water after treatment of PO in children with CHD and compare LUS score results with echo parameters and management protocol. Patients and methods: A cross-sectional study was conducted over 33 children with CHD and PO. Patients were subdivided into 3 groups according to management: percutaneous catheter closure (n=15), surgery (n=10), and medical treatment (n=8). Pulmonary congestion was identified using B-lines in LUS and/or chest X-ray (CXR). Twelve lung zones were scanned to calculate the B-line score. Changes were compared before- and after- management to monitor response. Results: Pre-intervention, 74% and 24% of patients showed moderate and severe lung congestion, respectively. Patients with severe LUS scores showed significantly higher Qp:Qs (p < 0.001), LA/Ao (p=0.00), LVEDd (p < 0.001), Rt & Lt MPI (P<0.001). LUS score was significantly higher among patients referred for surgery (p=0.001). Post-intervention, all patients showed significant decline in LUS score (p < 0.001). It was positively correlated with mean decline in Qp:Qs (r=0.33, p=0.007) & LA/Ao (r=o.72, p < 0.001) and negatively correlated with mean increase in EF% (r= -0.31, p=0.009) and FS% (r= -0.36, p=0.006). Mean LUS score decreased significantly post-catheter closure (p=0.03). | ||
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