Ultrasound for Perioperative Lung Monitoring of Patients Undergoing Thoracic Surgery with One-Lung Ventilation

Mari Sunohara; Akihiko Maeda; Yukiko Nakanishi; Eizo Amano; Toshiki Okada; Hiromi Shibuya

doi:10.18502/aacc.v9i3.13117

Mari Sunohara Department of Anesthesiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Osaka, Osaka, Japan.
Akihiko Maeda Department of Anesthesiology and Intensive Care Medicine, Sakurabashi-Watanabe Hospital, 2-4-32, Umeda, Osaka, Osaka, Japan.
Yukiko Nakanishi Department of Anesthesiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Osaka, Osaka, Japan.
Eizo Amano Department of Anesthesiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Osaka, Osaka, Japan.
Toshiki Okada Department of Anesthesiology and Palliative Care, Nissey Hospital, 2-1-54, Enokojima, Osaka, Osaka, Japan.
Hiromi Shibuya Department of Anesthesiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Osaka, Osaka, Japan.

DOI: https://doi.org/10.18502/aacc.v9i3.13117

Keywords: Diagnostic imaging; One-lung ventilation; Thoracic surgery; Lung ultrasonography

Abstract

Background: The diagnostic efficacy of lung ultrasonography (LUS) has been widely investigated. However, the clinical value of LUS for perioperative monitoring has rarely been reported. The aim of this study was to evaluate the ability of LUS to assess lung aeration status after one-lung ventilation (OLV) using a validated scoring system.

Methods: In this prospective observational study, patients undergoing elective video-assisted thoracic surgery (VATS) with OLV underwent a lung ultrasound examination just after induction of anesthesia and at the end of the surgery. After each lung ultrasound examination, a semiquantitative score, the LUS score, was calculated to assess lung aeration on the ventilated dependent side and the non-dependent side separately. The relationship between the LUS scores and various patient-related factors was also investigated.

Results: Twenty-five patients were studied. All lung ultrasound examinations were successfully completed. LUS scores after OLV on the dependent side (median [IQR]: 2 [1–4]) increased significantly from baseline (1 [0–1.5], P < 0.001). Further, LUS scores on the non-dependent side (2 [1.5–3.5]) increased significantly from baseline (1 [0–1.5], P < 0.001). None of the factors analyzed was significantly correlated with LUS scores after OLV.

Conclusion: LUS examination is possible after VATS with OLV on both sides of the thorax. Ultrasonography-measured lung aeration scores increased from baseline on both sides.