Abstract P-576: LUNG ULTRASOUND FINDINGS IN PULMONARY HEMORRHAGE IN CRITICALLY SICK CHILDREN

Abstract

Aims & Objectives: To describe lung ultrasound findings in critically sick children with pulmonary hemorrhage Methods We performed lung ultrsound (LUS) in two patients with pulmonary hemorrhage (PH). First case was a 13 year old girl with a diagnosis of chronic kidney disease with pulmonary edema. She had to be mechanically ventilated in view of respiratory distress and developed PH. Second case was a 12 years old boy admitted with severe dengue and bleeding diathesis. Ultrasound Technicque:LUS was performed with Aloka SSD-90 machine with a high frequency (7.5 MHz), linear transducer. Each lung was divided into six areas (superior and inferior of anterior, lateral and posterior zones). Anterior axillary line divided anterior from lateral and posterior axillary line divided lateral from posterior area. The probe orientation was perpendicular to the ribs. Results LUS showed alveolar-interstitial (AIS) pattern. It was different from ARDS in two ways, 1) the AIS pattern was patchy and; 2) the hyperechoic patches of AIS pattern were seen away from the pleural line. This may be because of focal areas of pulmonary bleeding. The air bronchograms were present. In one case pleural effusion was also seen. Conclusions The LUS findings in PH are very distinct. Presence of hyperechoic patches of B lines may signify focal hemorrhages.