• Pediatr Crit Care Me · Feb 2017

    Comparative Study Clinical Trial

    Bedside Ultrasound for the Diagnosis of Abnormal Diaphragmatic Motion in Children After Heart Surgery.

    • Laura Gil-Juanmiquel, Margarida Gratacós, Yolanda Castilla-Fernández, Joaquim Piqueras, Tracy Baust, Nuria Raguer, Joan Balcells, Santiago Perez-Hoyos, Raul F Abella, and Joan Sanchez-de-Toledo.
    • 1Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 2Department of Clinical Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 3Department of neonatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 4Department of Pediatric Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 5Cardiac Intensive Care Unit, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA. 6Unit of Clinical Research Support, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain. 7Department of Pediatric Cardiothoracic Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 8Department of Pediatric Cardiology, Sant Joan de Deu Barcelona Children's Hospital, University of Barcelona, Barcelona, Spain.
    • Pediatr Crit Care Me. 2017 Feb 1; 18 (2): 159-164.

    ObjectiveTo assess the utility of bedside ultrasound combining B- and M-mode in the diagnosis of abnormal diaphragmatic motion in children after heart surgery.DesignProspective post hoc blinded comparison of ultrasound performed by two different intensivists and fluoroscopy results with electromyography.SettingTertiary university hospital.SubjectsChildren with suspected abnormal diaphragmatic motion after heart surgery.InterventionsNone.Measurements And Main ResultsAbnormal diaphragmatic motion was suspected in 26 children. Electromyography confirmed the diagnosis in 20 of 24 children (83.3%). The overall occurrence rate of abnormal diaphragmatic motion during the study period was 7.5%. Median patient age was 5 months (range, 16 d to 14 yr). Sensitivity and specificity of chest ultrasound performed at the bedside by the two intensivists (91% and 92% and 92% and 95%, respectively) were higher than those obtained by fluoroscopy (87% and 83%). Interobserver agreement (k) between both intensivists was 0.957 (95% CI, 0.87-100).ConclusionsChest ultrasound performed by intensivists is a valid tool for the diagnosis of diaphragmatic paralysis, presenting greater sensitivity and specificity than fluoroscopy. Chest ultrasound should be routinely used after pediatric heart surgery given its reliability, reproducibility, availability, and safety.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…