The effect of fluids flushed in pediatric cardiac catheterization procedures on lung ultrasound score

Abstract

ABSTRACT Background Intravascular catheters used during cardiac catheterization require frequent flushing with heparinized solutions. Fluid overload is more common in pediatric patients with congenital heart diseases. This study aimed to determine the safe volume of fluids that can be used without congestion using the lung ultrasound score. Methodology A total of 42 patients aged from 1 month to 6 years undergoing diagnostic cardiac procedures were included in this study. The total volume of infused fluids, the volume of fluids used for flushing intravascular sheaths and catheters, the lung ultrasound score, and PaCO2 and PaO2 /FiO2 ratio were documented. Results There was a very strong positive relationship between the total fluid volume infused in ml/kg and the difference in the lung ultrasound score before and after fluid infusion (r = 0.841, P < 0.001). There was a very weak positive relationship between the total fluid volume infused in ml/kg and the difference in PaCO2 before and after fluid infusion (r = 0.217, P = 0.167). There was a weak negative relationship between the total fluid volume infused in ml/kg and the change in the PaO2 /FiO2 ratio (r = −0.21, P = 0.182). Conclusion A fluid flush volume of >11.3 ml/kg has a high probability of inducing volume load in pediatric patients undergoing cardiac catheterization. A flushing volume of 3.478 ml/kg affects the lung ultrasound score. Hence, we recommend reducing the volume of intravenous fluids if higher volumes are required for flushing.