Abstract Introduction: Lung ultrasound findings in cardiac patients correlate with mortality, hospital length of stay, and rehospitalisation after surgery. We report a lung ultrasound protocol integrated with echocardiography and its ability to predict adverse events in children after discharge following congenital heart surgery. Methods: A prospective, single-blinded observational trial was performed. Subjects were consecutively identified after Fontan or septal defect repairs. Performed by cardiac sonographers at discharge, lung ultrasound scores were based on the number of B-lines. The primary outcome was subsequent development of new pericardial (≥small) or pleural (>small) effusion. Results: A total of 86 subjects were identified with adequate imaging for enrolment. Median age was 53 months. Procedures included Fontan ( n = 23) and atrial ( n = 30), ventricular ( n = 28), and atrioventricular ( n = 5) septal defect repairs. Lung ultrasound score was correlated with hospital length of stay ( ρ = 0.29, p = 0.0066), discharge diuretic score ( ρ = 0.38, p < 0.001), and chest tube duration ( ρ = 0.25, p = 0.021); score was not correlated with age or weight. Primary outcome occurred in 12 subjects (atrial septal defect = 4, Fontan = 8). A lung ultrasound score ≥3 had a negative predictive value of 93% and an odds ratio of 24.5 (95%CI 5.3–113, p < 0.0001) for the primary outcome. Subjects following Fontan with the lung ultrasound score ≥3 had an odds ratio of 8.3 (95%CI 1.2–59.0, p < 0.036). Conclusions: Our results suggest that lung ultrasound during discharge echocardiography has encouraging prognostic value for post-operative complications in patients deemed suitable for discharge after congenital heart surgery. Further research is needed to discern how lung ultrasound can be used for goal-directed medical therapy.
Riley et al. (Fri,) studied this question.