Role of lung ultrasound in differentiating lung congestion and lung infection in paediatric cardiac patients

Abstract

INTRODUCTION: Lung sonography in the emergency situations became one of the most appropriate studies. This technique allows us to diagnose major causes of acute respiratory distress at the bedside without major interventions. It is easy, costless approach to diagnose many lung diseases. The success of this technique depends on its simplicity to discover the sonographic artifacts which indicate certain lung pathology. The A-profile associates anterior lung sliding with A lines. A lines are horizontal repetition artifacts of the pleural line. The B-profile associates anterior lung sliding with B lines. B lines appear as shining vertical lines arising from the pleural line and reach the edge of the screen. PATIENTS AND METHODS: A descriptive study included cardiac patients admitted to the pediatric cardiology ward for six months. They had their data completely revised and their treatment recorded and diagnosis traced with a direct question: is it congestion or infection. A lung ultrasound was done to try to assure the diagnosis. Also, chest x ray and echo correlation were assessed. RESULTS: Sixty patients were enrolled over a period of six months (58% male, with the mean age ± SD was (17.33 ± 30.91) months. Twenty-seven of the sixty patients had a B-profile, thirty-five had A-profile, A&B profile was found in six cases, hypoechoic areas were found in nine cases. Lung ultrasound appeared to be normal in three cases. CONCLUSION: By applying use of lung ultrasound in pediatric cardiology ward to diagnose or to confirm the diagnosis of chest infection, air trapping, lung congestion up to pulmonary edema, thus differentiating which line of treatment is better to the patients, antibiotics or bronchodilators or antifailure medication avoiding blind use of antibiotics.